| National Provider Identifier [NPI]: | 1225200744 |
| Last Name Of The Provider | WEISS |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 75 FRANCIS ST |
| Street Address 2 Of The Provider | RADIOLOGY DEPARTMENT |
| City Of The Provider | BOSTON |
| Zip Code Of The Provider | 021156110 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 173 |
| Number Of Services | 3140 |
| Number Of Medicare Beneficiaries | 2189 |
| Total Submitted Charge Amount | 327107 |
| Total Medicare Allowed Amount | 108310.77 |
| Total Medicare Payment Amount | 84799.07 |
| Total Medicare Standardized Payment Amount | 84023.84 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 173 |
| Number Of Medical Services | 3140 |
| Number Of Medicare Beneficiaries With Medical Services | 2189 |
| Total Medical Submitted Charge Amount | 327107 |
| Total Medical Medicare Allowed Amount | 108310.77 |
| Total Medical Medicare Payment Amount | 84799.07 |
| Total Medical Medicare Standardized Payment Amount | 84023.84 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 334 |
| Number Of Beneficiaries Age 65 to 74 | 836 |
| Number Of Beneficiaries Age 75 to 84 | 601 |
| Number Of Beneficiaries Age Greater 84 | 418 |
| Number Of Female Beneficiaries | 1327 |
| Number Of Male Beneficiaries | 862 |
| Number Of Non Hispanic White Beneficiaries | 2054 |
| Number Of Black or African American Beneficiaries | 22 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 61 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 29 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1780 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 409 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.4791 |