| National Provider Identifier [NPI]: | 1033369327 |
| Last Name Of The Provider | WEISS |
| First Name Of The Provider | JOSHUA |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 836 W WELLINGTON AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | CHICAGO |
| Zip Code Of The Provider | 606575147 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 155 |
| Number Of Services | 4843 |
| Number Of Medicare Beneficiaries | 2909 |
| Total Submitted Charge Amount | 490901 |
| Total Medicare Allowed Amount | 140092.81 |
| Total Medicare Payment Amount | 108695.38 |
| Total Medicare Standardized Payment Amount | 103654.29 |
| 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 | 155 |
| Number Of Medical Services | 4843 |
| Number Of Medicare Beneficiaries With Medical Services | 2909 |
| Total Medical Submitted Charge Amount | 490901 |
| Total Medical Medicare Allowed Amount | 140092.81 |
| Total Medical Medicare Payment Amount | 108695.38 |
| Total Medical Medicare Standardized Payment Amount | 103654.29 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 294 |
| Number Of Beneficiaries Age 65 to 74 | 1248 |
| Number Of Beneficiaries Age 75 to 84 | 919 |
| Number Of Beneficiaries Age Greater 84 | 448 |
| Number Of Female Beneficiaries | 1951 |
| Number Of Male Beneficiaries | 958 |
| Number Of Non Hispanic White Beneficiaries | 2539 |
| Number Of Black or African American Beneficiaries | 85 |
| Number Of AsianPacific Islander Beneficiaries | 44 |
| Number Of Hispanic Beneficiaries | 201 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2483 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 426 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.4403 |