| National Provider Identifier [NPI]: | 1447451570 |
| Last Name Of The Provider | WEISS |
| First Name Of The Provider | JEREMY |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4545 E 9TH AVE |
| Street Address 2 Of The Provider | STE. #480 |
| City Of The Provider | DENVER |
| Zip Code Of The Provider | 80220 |
| State Code Of The Provider | CO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 77 |
| Number Of Services | 5583 |
| Number Of Medicare Beneficiaries | 564 |
| Total Submitted Charge Amount | 486221.56 |
| Total Medicare Allowed Amount | 240774.22 |
| Total Medicare Payment Amount | 179889.33 |
| Total Medicare Standardized Payment Amount | 185873.59 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 2831 |
| Number Of Medicare Beneficiaries With Drug Services | 29 |
| Total Drug Submitted ChargeAmount | 51808 |
| Total Drug Medicare AllowedAmount | 33833.6 |
| Total Drug Medicare PaymentAmount | 25423.18 |
| Total Drug Medicare Standardized Payment Amount | 25423.18 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 71 |
| Number Of Medical Services | 2752 |
| Number Of Medicare Beneficiaries With Medical Services | 564 |
| Total Medical Submitted Charge Amount | 434413.56 |
| Total Medical Medicare Allowed Amount | 206940.62 |
| Total Medical Medicare Payment Amount | 154466.15 |
| Total Medical Medicare Standardized Payment Amount | 160450.41 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 63 |
| Number Of Beneficiaries Age 65 to 74 | 220 |
| Number Of Beneficiaries Age 75 to 84 | 185 |
| Number Of Beneficiaries Age Greater 84 | 96 |
| Number Of Female Beneficiaries | 127 |
| Number Of Male Beneficiaries | 437 |
| Number Of Non Hispanic White Beneficiaries | 453 |
| Number Of Black or African American Beneficiaries | 32 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 61 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 445 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 119 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.2699 |