| National Provider Identifier [NPI]: | 1598928582 |
| Last Name Of The Provider | WEIS-MCNULTY |
| First Name Of The Provider | ANNETTE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD PHD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6449 38TH AVE N |
| Street Address 2 Of The Provider | SUITE C4 |
| City Of The Provider | ST PETERSBURG |
| Zip Code Of The Provider | 337101655 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 186 |
| Number Of Services | 5297 |
| Number Of Medicare Beneficiaries | 3063 |
| Total Submitted Charge Amount | 1105720 |
| Total Medicare Allowed Amount | 172669.04 |
| Total Medicare Payment Amount | 134341.98 |
| Total Medicare Standardized Payment Amount | 132941.13 |
| 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 | 186 |
| Number Of Medical Services | 5297 |
| Number Of Medicare Beneficiaries With Medical Services | 3063 |
| Total Medical Submitted Charge Amount | 1105720 |
| Total Medical Medicare Allowed Amount | 172669.04 |
| Total Medical Medicare Payment Amount | 134341.98 |
| Total Medical Medicare Standardized Payment Amount | 132941.13 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 728 |
| Number Of Beneficiaries Age 65 to 74 | 762 |
| Number Of Beneficiaries Age 75 to 84 | 823 |
| Number Of Beneficiaries Age Greater 84 | 750 |
| Number Of Female Beneficiaries | 1862 |
| Number Of Male Beneficiaries | 1201 |
| Number Of Non Hispanic White Beneficiaries | 2438 |
| Number Of Black or African American Beneficiaries | 301 |
| Number Of AsianPacific Islander Beneficiaries | 40 |
| Number Of Hispanic Beneficiaries | 251 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1692 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1371 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 35 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 44 |
| Percent Of With Chronic Kidney Disease | 52 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 48 |
| Percent Of With Depression | 46 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 61 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 16 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.2717 |