| National Provider Identifier [NPI]: | 1427168616 |
| Last Name Of The Provider | WEISS |
| First Name Of The Provider | SHELDON |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3401 N PERRYVILLE RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | ROCKFORD |
| Zip Code Of The Provider | 611148011 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 62 |
| Number Of Services | 3374 |
| Number Of Medicare Beneficiaries | 699 |
| Total Submitted Charge Amount | 329691.65 |
| Total Medicare Allowed Amount | 202816.38 |
| Total Medicare Payment Amount | 140310 |
| Total Medicare Standardized Payment Amount | 148967.54 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 1036 |
| Number Of Medicare Beneficiaries With Drug Services | 304 |
| Total Drug Submitted ChargeAmount | 25810 |
| Total Drug Medicare AllowedAmount | 14765.42 |
| Total Drug Medicare PaymentAmount | 13869.95 |
| Total Drug Medicare Standardized Payment Amount | 13869.95 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 49 |
| Number Of Medical Services | 2338 |
| Number Of Medicare Beneficiaries With Medical Services | 699 |
| Total Medical Submitted Charge Amount | 303881.65 |
| Total Medical Medicare Allowed Amount | 188050.96 |
| Total Medical Medicare Payment Amount | 126440.05 |
| Total Medical Medicare Standardized Payment Amount | 135097.59 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 62 |
| Number Of Beneficiaries Age 65 to 74 | 272 |
| Number Of Beneficiaries Age 75 to 84 | 236 |
| Number Of Beneficiaries Age Greater 84 | 129 |
| Number Of Female Beneficiaries | 349 |
| Number Of Male Beneficiaries | 350 |
| Number Of Non Hispanic White Beneficiaries | 619 |
| Number Of Black or African American Beneficiaries | 61 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 610 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 89 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0148 |