| National Provider Identifier [NPI]: | 1871564724 |
| Last Name Of The Provider | WEISBERG |
| First Name Of The Provider | TRACEY |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 100 CAMPUS DRIVE |
| Street Address 2 Of The Provider | SUITE 108 |
| City Of The Provider | SCARBOROUGH |
| Zip Code Of The Provider | 04074 |
| State Code Of The Provider | ME |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 137 |
| Number Of Services | 73721 |
| Number Of Medicare Beneficiaries | 750 |
| Total Submitted Charge Amount | 2593913.31 |
| Total Medicare Allowed Amount | 1622613.43 |
| Total Medicare Payment Amount | 1271219.43 |
| Total Medicare Standardized Payment Amount | 1268882.98 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 65 |
| Number Of Drug Services | 66176 |
| Number Of Medicare Beneficiaries With Drug Services | 209 |
| Total Drug Submitted ChargeAmount | 1910644.36 |
| Total Drug Medicare AllowedAmount | 1344953.16 |
| Total Drug Medicare PaymentAmount | 1050086.36 |
| Total Drug Medicare Standardized Payment Amount | 1050086.36 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 72 |
| Number Of Medical Services | 7545 |
| Number Of Medicare Beneficiaries With Medical Services | 750 |
| Total Medical Submitted Charge Amount | 683268.95 |
| Total Medical Medicare Allowed Amount | 277660.27 |
| Total Medical Medicare Payment Amount | 221133.07 |
| Total Medical Medicare Standardized Payment Amount | 218796.62 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 86 |
| Number Of Beneficiaries Age 65 to 74 | 385 |
| Number Of Beneficiaries Age 75 to 84 | 202 |
| Number Of Beneficiaries Age Greater 84 | 77 |
| Number Of Female Beneficiaries | 645 |
| Number Of Male Beneficiaries | 105 |
| Number Of Non Hispanic White Beneficiaries | 728 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| 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 | 600 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 150 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 75 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 20 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 29 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.3148 |