| National Provider Identifier [NPI]: | 1982604666 |
| Last Name Of The Provider | WEISS |
| First Name Of The Provider | PAUL |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 380 N 200 W |
| Street Address 2 Of The Provider | SUITE 209 |
| City Of The Provider | BOUNTIFUL |
| Zip Code Of The Provider | 840107079 |
| State Code Of The Provider | UT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 187 |
| Number Of Services | 5016 |
| Number Of Medicare Beneficiaries | 2661 |
| Total Submitted Charge Amount | 372855.11 |
| Total Medicare Allowed Amount | 134207.92 |
| Total Medicare Payment Amount | 103888.51 |
| Total Medicare Standardized Payment Amount | 107569.03 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 686 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 9702.2 |
| Total Drug Medicare AllowedAmount | 7399.62 |
| Total Drug Medicare PaymentAmount | 5801.28 |
| Total Drug Medicare Standardized Payment Amount | 5801.28 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 184 |
| Number Of Medical Services | 4330 |
| Number Of Medicare Beneficiaries With Medical Services | 2661 |
| Total Medical Submitted Charge Amount | 363152.91 |
| Total Medical Medicare Allowed Amount | 126808.3 |
| Total Medical Medicare Payment Amount | 98087.23 |
| Total Medical Medicare Standardized Payment Amount | 101767.75 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 277 |
| Number Of Beneficiaries Age 65 to 74 | 1118 |
| Number Of Beneficiaries Age 75 to 84 | 823 |
| Number Of Beneficiaries Age Greater 84 | 443 |
| Number Of Female Beneficiaries | 1838 |
| Number Of Male Beneficiaries | 823 |
| Number Of Non Hispanic White Beneficiaries | 2443 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 40 |
| Number Of Hispanic Beneficiaries | 117 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 33 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2354 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 307 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.2729 |