| National Provider Identifier [NPI]: | 1033395165 |
| Last Name Of The Provider | WEISMAN |
| First Name Of The Provider | NICHOLAS |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1200 N STATE ST RM 3550 |
| Street Address 2 Of The Provider | |
| City Of The Provider | LOS ANGELES |
| Zip Code Of The Provider | 900331029 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 235 |
| Number Of Services | 6751 |
| Number Of Medicare Beneficiaries | 4328 |
| Total Submitted Charge Amount | 934407 |
| Total Medicare Allowed Amount | 276109.02 |
| Total Medicare Payment Amount | 211280.69 |
| Total Medicare Standardized Payment Amount | 215222.56 |
| 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 | 235 |
| Number Of Medical Services | 6751 |
| Number Of Medicare Beneficiaries With Medical Services | 4328 |
| Total Medical Submitted Charge Amount | 934407 |
| Total Medical Medicare Allowed Amount | 276109.02 |
| Total Medical Medicare Payment Amount | 211280.69 |
| Total Medical Medicare Standardized Payment Amount | 215222.56 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 244 |
| Number Of Beneficiaries Age 65 to 74 | 1445 |
| Number Of Beneficiaries Age 75 to 84 | 1563 |
| Number Of Beneficiaries Age Greater 84 | 1076 |
| Number Of Female Beneficiaries | 2466 |
| Number Of Male Beneficiaries | 1862 |
| Number Of Non Hispanic White Beneficiaries | 3993 |
| Number Of Black or African American Beneficiaries | 101 |
| Number Of AsianPacific Islander Beneficiaries | 33 |
| Number Of Hispanic Beneficiaries | 146 |
| Number Of American Indian Alaska Native Beneficiaries | 16 |
| Number Of Beneficiaries With Race Not Else where Classified | 39 |
| Number Of Beneficiaries With Medicare Only Entitlement | 4002 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 326 |
| Percent Of With Atrial Fibrillation | 24 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 1.6735 |