| National Provider Identifier [NPI]: | 1508816901 |
| Last Name Of The Provider | WEINER |
| First Name Of The Provider | LAWRENCE |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7900 N MILWAUKEE AVE |
| Street Address 2 Of The Provider | 18 |
| City Of The Provider | NILES |
| Zip Code Of The Provider | 607143159 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 81 |
| Number Of Services | 7993 |
| Number Of Medicare Beneficiaries | 566 |
| Total Submitted Charge Amount | 615693 |
| Total Medicare Allowed Amount | 303702.87 |
| Total Medicare Payment Amount | 230690.88 |
| Total Medicare Standardized Payment Amount | 215206.24 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 292 |
| Number Of Medicare Beneficiaries With Drug Services | 258 |
| Total Drug Submitted ChargeAmount | 13880 |
| Total Drug Medicare AllowedAmount | 10074.98 |
| Total Drug Medicare PaymentAmount | 9711.06 |
| Total Drug Medicare Standardized Payment Amount | 9711.06 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 73 |
| Number Of Medical Services | 7701 |
| Number Of Medicare Beneficiaries With Medical Services | 565 |
| Total Medical Submitted Charge Amount | 601813 |
| Total Medical Medicare Allowed Amount | 293627.89 |
| Total Medical Medicare Payment Amount | 220979.82 |
| Total Medical Medicare Standardized Payment Amount | 205495.18 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 19 |
| Number Of Beneficiaries Age 65 to 74 | 179 |
| Number Of Beneficiaries Age 75 to 84 | 228 |
| Number Of Beneficiaries Age Greater 84 | 140 |
| Number Of Female Beneficiaries | 297 |
| Number Of Male Beneficiaries | 269 |
| Number Of Non Hispanic White Beneficiaries | 535 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 12 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 549 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 17 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.0827 |