| National Provider Identifier [NPI]: | 1821072489 |
| Last Name Of The Provider | WEISS |
| First Name Of The Provider | LAURENCE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 97 BARNES RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | WALLINGFORD |
| Zip Code Of The Provider | 064921885 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 167 |
| Number Of Services | 15342 |
| Number Of Medicare Beneficiaries | 1796 |
| Total Submitted Charge Amount | 515372.09 |
| Total Medicare Allowed Amount | 217345.41 |
| Total Medicare Payment Amount | 173362.96 |
| Total Medicare Standardized Payment Amount | 161790.65 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 12500 |
| Number Of Medicare Beneficiaries With Drug Services | 105 |
| Total Drug Submitted ChargeAmount | 12500 |
| Total Drug Medicare AllowedAmount | 2361.43 |
| Total Drug Medicare PaymentAmount | 1758.03 |
| Total Drug Medicare Standardized Payment Amount | 1758.03 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 166 |
| Number Of Medical Services | 2842 |
| Number Of Medicare Beneficiaries With Medical Services | 1796 |
| Total Medical Submitted Charge Amount | 502872.09 |
| Total Medical Medicare Allowed Amount | 214983.98 |
| Total Medical Medicare Payment Amount | 171604.93 |
| Total Medical Medicare Standardized Payment Amount | 160032.62 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 219 |
| Number Of Beneficiaries Age 65 to 74 | 584 |
| Number Of Beneficiaries Age 75 to 84 | 518 |
| Number Of Beneficiaries Age Greater 84 | 475 |
| Number Of Female Beneficiaries | 1274 |
| Number Of Male Beneficiaries | 522 |
| Number Of Non Hispanic White Beneficiaries | 1608 |
| Number Of Black or African American Beneficiaries | 50 |
| Number Of AsianPacific Islander Beneficiaries | 25 |
| Number Of Hispanic Beneficiaries | 102 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 11 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1182 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 614 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 24 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.5251 |