| National Provider Identifier [NPI]: | 1356523435 |
| Last Name Of The Provider | FAVIS |
| First Name Of The Provider | WEENA |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 33041 PROFESSIONAL DR |
| Street Address 2 Of The Provider | SUITE 101 |
| City Of The Provider | LEESBURG |
| Zip Code Of The Provider | 347883760 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 45 |
| Number Of Services | 4857 |
| Number Of Medicare Beneficiaries | 599 |
| Total Submitted Charge Amount | 423664 |
| Total Medicare Allowed Amount | 301895.82 |
| Total Medicare Payment Amount | 215242.91 |
| Total Medicare Standardized Payment Amount | 215983.46 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 1177 |
| Number Of Medicare Beneficiaries With Drug Services | 213 |
| Total Drug Submitted ChargeAmount | 38245 |
| Total Drug Medicare AllowedAmount | 17014.35 |
| Total Drug Medicare PaymentAmount | 13843.31 |
| Total Drug Medicare Standardized Payment Amount | 13843.31 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 40 |
| Number Of Medical Services | 3680 |
| Number Of Medicare Beneficiaries With Medical Services | 599 |
| Total Medical Submitted Charge Amount | 385419 |
| Total Medical Medicare Allowed Amount | 284881.47 |
| Total Medical Medicare Payment Amount | 201399.6 |
| Total Medical Medicare Standardized Payment Amount | 202140.15 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 21 |
| Number Of Beneficiaries Age 65 to 74 | 257 |
| Number Of Beneficiaries Age 75 to 84 | 249 |
| Number Of Beneficiaries Age Greater 84 | 72 |
| Number Of Female Beneficiaries | 406 |
| Number Of Male Beneficiaries | 193 |
| Number Of Non Hispanic White Beneficiaries | 580 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 577 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 22 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 0.9789 |