| National Provider Identifier [NPI]: | 1073695185 |
| Last Name Of The Provider | WEBER |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | RPA-C |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2500 NESCONSET HWY |
| Street Address 2 Of The Provider | BUILDING 7D |
| City Of The Provider | STONY BROOK |
| Zip Code Of The Provider | 117902555 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 21 |
| Number Of Services | 432 |
| Number Of Medicare Beneficiaries | 166 |
| Total Submitted Charge Amount | 53005 |
| Total Medicare Allowed Amount | 20427.71 |
| Total Medicare Payment Amount | 16504.38 |
| Total Medicare Standardized Payment Amount | 16558.56 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 58 |
| Number Of Medicare Beneficiaries With Drug Services | 56 |
| Total Drug Submitted ChargeAmount | 1415 |
| Total Drug Medicare AllowedAmount | 748.14 |
| Total Drug Medicare PaymentAmount | 732.75 |
| Total Drug Medicare Standardized Payment Amount | 732.75 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 17 |
| Number Of Medical Services | 374 |
| Number Of Medicare Beneficiaries With Medical Services | 166 |
| Total Medical Submitted Charge Amount | 51590 |
| Total Medical Medicare Allowed Amount | 19679.57 |
| Total Medical Medicare Payment Amount | 15771.63 |
| Total Medical Medicare Standardized Payment Amount | 15825.81 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 16 |
| Number Of Beneficiaries Age 65 to 74 | 93 |
| Number Of Beneficiaries Age 75 to 84 | 38 |
| Number Of Beneficiaries Age Greater 84 | 19 |
| Number Of Female Beneficiaries | 87 |
| Number Of Male Beneficiaries | 79 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 8 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0823 |