| National Provider Identifier [NPI]: | 1851318331 |
| Last Name Of The Provider | WEAVER |
| First Name Of The Provider | JONATHAN |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2121 WILSHIRE BLVD |
| Street Address 2 Of The Provider | #103 |
| City Of The Provider | SANTA MONICA |
| Zip Code Of The Provider | 90403 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 80 |
| Number Of Services | 8678 |
| Number Of Medicare Beneficiaries | 509 |
| Total Submitted Charge Amount | 354038.6 |
| Total Medicare Allowed Amount | 305939.36 |
| Total Medicare Payment Amount | 246153.94 |
| Total Medicare Standardized Payment Amount | 240587.35 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 290 |
| Number Of Medicare Beneficiaries With Drug Services | 161 |
| Total Drug Submitted ChargeAmount | 4399 |
| Total Drug Medicare AllowedAmount | 4110.51 |
| Total Drug Medicare PaymentAmount | 3896.92 |
| Total Drug Medicare Standardized Payment Amount | 3896.92 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 71 |
| Number Of Medical Services | 8388 |
| Number Of Medicare Beneficiaries With Medical Services | 509 |
| Total Medical Submitted Charge Amount | 349639.6 |
| Total Medical Medicare Allowed Amount | 301828.85 |
| Total Medical Medicare Payment Amount | 242257.02 |
| Total Medical Medicare Standardized Payment Amount | 236690.43 |
| Average Age Of Beneficiaries | 81 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | 155 |
| Number Of Beneficiaries Age Greater 84 | 202 |
| Number Of Female Beneficiaries | 282 |
| Number Of Male Beneficiaries | 227 |
| Number Of Non Hispanic White Beneficiaries | 477 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 14 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 5 |
| Percent Of With Depression | 9 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 50 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1179 |