| National Provider Identifier [NPI]: | 1083612345 |
| Last Name Of The Provider | WEAVER |
| First Name Of The Provider | ANNE |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 29 COTTAGE ST |
| Street Address 2 Of The Provider | SUITE C |
| City Of The Provider | AMHERST |
| Zip Code Of The Provider | 010022172 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 47 |
| Number Of Services | 884 |
| Number Of Medicare Beneficiaries | 190 |
| Total Submitted Charge Amount | 107263 |
| Total Medicare Allowed Amount | 66001.37 |
| Total Medicare Payment Amount | 50412.91 |
| Total Medicare Standardized Payment Amount | 49329.3 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 143 |
| Number Of Medicare Beneficiaries With Drug Services | 101 |
| Total Drug Submitted ChargeAmount | 12593 |
| Total Drug Medicare AllowedAmount | 9662.92 |
| Total Drug Medicare PaymentAmount | 9461.4 |
| Total Drug Medicare Standardized Payment Amount | 9461.4 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 40 |
| Number Of Medical Services | 741 |
| Number Of Medicare Beneficiaries With Medical Services | 189 |
| Total Medical Submitted Charge Amount | 94670 |
| Total Medical Medicare Allowed Amount | 56338.45 |
| Total Medical Medicare Payment Amount | 40951.51 |
| Total Medical Medicare Standardized Payment Amount | 39867.9 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 25 |
| Number Of Beneficiaries Age 65 to 74 | 82 |
| Number Of Beneficiaries Age 75 to 84 | 43 |
| Number Of Beneficiaries Age Greater 84 | 40 |
| Number Of Female Beneficiaries | 149 |
| Number Of Male Beneficiaries | 41 |
| Number Of Non Hispanic White Beneficiaries | 168 |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 149 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 41 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 8 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 14 |
| Percent Of With Hyperlipidemia | 26 |
| Percent Of With Hypertension | 33 |
| Percent Of With Ischemic Heart Disease | 8 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 28 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8598 |