| National Provider Identifier [NPI]: | 1043294903 |
| Last Name Of The Provider | WEBER |
| First Name Of The Provider | THERESE |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 619 19TH STREET SOUTH |
| Street Address 2 Of The Provider | |
| City Of The Provider | BIRMINGHAM |
| Zip Code Of The Provider | 35233 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 93 |
| Number Of Services | 13247 |
| Number Of Medicare Beneficiaries | 2344 |
| Total Submitted Charge Amount | 1008264 |
| Total Medicare Allowed Amount | 180247.77 |
| Total Medicare Payment Amount | 131624.96 |
| Total Medicare Standardized Payment Amount | 149081.39 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 10148 |
| Number Of Medicare Beneficiaries With Drug Services | 86 |
| Total Drug Submitted ChargeAmount | 10439 |
| Total Drug Medicare AllowedAmount | 1990.27 |
| Total Drug Medicare PaymentAmount | 1274.89 |
| Total Drug Medicare Standardized Payment Amount | 1274.89 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 91 |
| Number Of Medical Services | 3099 |
| Number Of Medicare Beneficiaries With Medical Services | 2344 |
| Total Medical Submitted Charge Amount | 997825 |
| Total Medical Medicare Allowed Amount | 178257.5 |
| Total Medical Medicare Payment Amount | 130350.07 |
| Total Medical Medicare Standardized Payment Amount | 147806.5 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 827 |
| Number Of Beneficiaries Age 65 to 74 | 924 |
| Number Of Beneficiaries Age 75 to 84 | 452 |
| Number Of Beneficiaries Age Greater 84 | 141 |
| Number Of Female Beneficiaries | 1148 |
| Number Of Male Beneficiaries | 1196 |
| Number Of Non Hispanic White Beneficiaries | 1580 |
| Number Of Black or African American Beneficiaries | 712 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 20 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 20 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1702 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 642 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 53 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 2.3326 |