| National Provider Identifier [NPI]: | 1285622662 |
| Last Name Of The Provider | WEISE |
| First Name Of The Provider | RICHARD |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 607 N CENTRAL AVE |
| Street Address 2 Of The Provider | SUITE 105 |
| City Of The Provider | GLENDALE |
| Zip Code Of The Provider | 912031804 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 57 |
| Number Of Services | 13917 |
| Number Of Medicare Beneficiaries | 2211 |
| Total Submitted Charge Amount | 7335944.5 |
| Total Medicare Allowed Amount | 2918142.68 |
| Total Medicare Payment Amount | 2226604.31 |
| Total Medicare Standardized Payment Amount | 1611115.93 |
| 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 | 57 |
| Number Of Medical Services | 13917 |
| Number Of Medicare Beneficiaries With Medical Services | 2211 |
| Total Medical Submitted Charge Amount | 7335944.5 |
| Total Medical Medicare Allowed Amount | 2918142.68 |
| Total Medical Medicare Payment Amount | 2226604.31 |
| Total Medical Medicare Standardized Payment Amount | 1611115.93 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 206 |
| Number Of Beneficiaries Age 65 to 74 | 786 |
| Number Of Beneficiaries Age 75 to 84 | 829 |
| Number Of Beneficiaries Age Greater 84 | 390 |
| Number Of Female Beneficiaries | 1510 |
| Number Of Male Beneficiaries | 701 |
| Number Of Non Hispanic White Beneficiaries | 820 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 180 |
| Number Of Hispanic Beneficiaries | 1118 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 51 |
| Number Of Beneficiaries With Medicare Only Entitlement | 684 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1527 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 51 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.428 |