| National Provider Identifier [NPI]: | 1730271412 |
| Last Name Of The Provider | WEAKLEY |
| First Name Of The Provider | TIFFANY |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2221 SE OCEAN BLVD |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | STUART |
| Zip Code Of The Provider | 349963341 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 43 |
| Number Of Services | 2947 |
| Number Of Medicare Beneficiaries | 914 |
| Total Submitted Charge Amount | 323987.71 |
| Total Medicare Allowed Amount | 279853.7 |
| Total Medicare Payment Amount | 221828.23 |
| Total Medicare Standardized Payment Amount | 209300.29 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 82 |
| Number Of Medicare Beneficiaries With Drug Services | 40 |
| Total Drug Submitted ChargeAmount | 1505 |
| Total Drug Medicare AllowedAmount | 676.23 |
| Total Drug Medicare PaymentAmount | 598.11 |
| Total Drug Medicare Standardized Payment Amount | 598.11 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 37 |
| Number Of Medical Services | 2865 |
| Number Of Medicare Beneficiaries With Medical Services | 914 |
| Total Medical Submitted Charge Amount | 322482.71 |
| Total Medical Medicare Allowed Amount | 279177.47 |
| Total Medical Medicare Payment Amount | 221230.12 |
| Total Medical Medicare Standardized Payment Amount | 208702.18 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 22 |
| Number Of Beneficiaries Age 65 to 74 | 333 |
| Number Of Beneficiaries Age 75 to 84 | 402 |
| Number Of Beneficiaries Age Greater 84 | 157 |
| Number Of Female Beneficiaries | 627 |
| Number Of Male Beneficiaries | 287 |
| Number Of Non Hispanic White Beneficiaries | 883 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 16 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 897 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 17 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 19 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1342 |