| National Provider Identifier [NPI]: | 1871534560 |
| Last Name Of The Provider | WEAVER |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 722 N STATE ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | BELLINGHAM |
| Zip Code Of The Provider | 982255334 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 30 |
| Number Of Services | 297 |
| Number Of Medicare Beneficiaries | 101 |
| Total Submitted Charge Amount | 41801 |
| Total Medicare Allowed Amount | 22239.45 |
| Total Medicare Payment Amount | 14466.71 |
| Total Medicare Standardized Payment Amount | 14922.63 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 23 |
| Number Of Medicare Beneficiaries With Drug Services | 14 |
| Total Drug Submitted ChargeAmount | 320 |
| Total Drug Medicare AllowedAmount | 223.22 |
| Total Drug Medicare PaymentAmount | 205.88 |
| Total Drug Medicare Standardized Payment Amount | 205.88 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 22 |
| Number Of Medical Services | 274 |
| Number Of Medicare Beneficiaries With Medical Services | 101 |
| Total Medical Submitted Charge Amount | 41481 |
| Total Medical Medicare Allowed Amount | 22016.23 |
| Total Medical Medicare Payment Amount | 14260.83 |
| Total Medical Medicare Standardized Payment Amount | 14716.75 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 58 |
| Number Of Beneficiaries Age 75 to 84 | 25 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 37 |
| Number Of Male Beneficiaries | 64 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 90 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 11 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 19 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 22 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.916 |