| National Provider Identifier [NPI]: | 1356517296 |
| Last Name Of The Provider | WELLER |
| First Name Of The Provider | DANIEL |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 101 PAGE ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | NEW BEDFORD |
| Zip Code Of The Provider | 027403464 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 185 |
| Number Of Services | 9665 |
| Number Of Medicare Beneficiaries | 5760 |
| Total Submitted Charge Amount | 812098 |
| Total Medicare Allowed Amount | 299314.87 |
| Total Medicare Payment Amount | 226805.48 |
| Total Medicare Standardized Payment Amount | 226883.15 |
| Drug Suppress Indicator | * |
| Number Of HCPCS Associated With Drug Services | |
| Number Of Drug Services | |
| Number Of Medicare Beneficiaries With Drug Services | |
| Total Drug Submitted ChargeAmount | |
| Total Drug Medicare AllowedAmount | |
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| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
| Number Of Medical Services | |
| Number Of Medicare Beneficiaries With Medical Services | |
| Total Medical Submitted Charge Amount | |
| Total Medical Medicare Allowed Amount | |
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| Total Medical Medicare Standardized Payment Amount | |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 1449 |
| Number Of Beneficiaries Age 65 to 74 | 1981 |
| Number Of Beneficiaries Age 75 to 84 | 1415 |
| Number Of Beneficiaries Age Greater 84 | 915 |
| Number Of Female Beneficiaries | 3737 |
| Number Of Male Beneficiaries | 2023 |
| Number Of Non Hispanic White Beneficiaries | 4893 |
| Number Of Black or African American Beneficiaries | 206 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 468 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 162 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3364 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 2396 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.5133 |