| National Provider Identifier [NPI]: | 1487631123 |
| Last Name Of The Provider | WEISS |
| First Name Of The Provider | JEREMY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 275 SW 160TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | BURIEN |
| Zip Code Of The Provider | 981663003 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 197 |
| Number Of Services | 2729 |
| Number Of Medicare Beneficiaries | 1505 |
| Total Submitted Charge Amount | 351390.94 |
| Total Medicare Allowed Amount | 100001.3 |
| Total Medicare Payment Amount | 74775.65 |
| Total Medicare Standardized Payment Amount | 73201.49 |
| 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 | 197 |
| Number Of Medical Services | 2729 |
| Number Of Medicare Beneficiaries With Medical Services | 1505 |
| Total Medical Submitted Charge Amount | 351390.94 |
| Total Medical Medicare Allowed Amount | 100001.3 |
| Total Medical Medicare Payment Amount | 74775.65 |
| Total Medical Medicare Standardized Payment Amount | 73201.49 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 250 |
| Number Of Beneficiaries Age 65 to 74 | 488 |
| Number Of Beneficiaries Age 75 to 84 | 462 |
| Number Of Beneficiaries Age Greater 84 | 305 |
| Number Of Female Beneficiaries | 840 |
| Number Of Male Beneficiaries | 665 |
| Number Of Non Hispanic White Beneficiaries | 1176 |
| Number Of Black or African American Beneficiaries | 80 |
| Number Of AsianPacific Islander Beneficiaries | 123 |
| Number Of Hispanic Beneficiaries | 55 |
| Number Of American Indian Alaska Native Beneficiaries | 23 |
| Number Of Beneficiaries With Race Not Else where Classified | 48 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1072 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 433 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.6677 |