| National Provider Identifier [NPI]: | 1437295144 |
| Last Name Of The Provider | WEINER |
| First Name Of The Provider | GLENN |
| Middle Initial Of The Provider | I |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 800 BIESTERFIELD RD |
| Street Address 2 Of The Provider | SUITE 4003 |
| City Of The Provider | ELK GROVE VILLAGE |
| Zip Code Of The Provider | 600073668 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 34 |
| Number Of Services | 32432 |
| Number Of Medicare Beneficiaries | 340 |
| Total Submitted Charge Amount | 854649.04 |
| Total Medicare Allowed Amount | 573709.85 |
| Total Medicare Payment Amount | 437921.76 |
| Total Medicare Standardized Payment Amount | 434601.48 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 31108 |
| Number Of Medicare Beneficiaries With Drug Services | 106 |
| Total Drug Submitted ChargeAmount | 602369.04 |
| Total Drug Medicare AllowedAmount | 431174.5 |
| Total Drug Medicare PaymentAmount | 333746.03 |
| Total Drug Medicare Standardized Payment Amount | 333746.03 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 23 |
| Number Of Medical Services | 1324 |
| Number Of Medicare Beneficiaries With Medical Services | 339 |
| Total Medical Submitted Charge Amount | 252280 |
| Total Medical Medicare Allowed Amount | 142535.35 |
| Total Medical Medicare Payment Amount | 104175.73 |
| Total Medical Medicare Standardized Payment Amount | 100855.45 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 33 |
| Number Of Beneficiaries Age 65 to 74 | 167 |
| Number Of Beneficiaries Age 75 to 84 | 116 |
| Number Of Beneficiaries Age Greater 84 | 24 |
| Number Of Female Beneficiaries | 231 |
| Number Of Male Beneficiaries | 109 |
| Number Of Non Hispanic White Beneficiaries | 300 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 17 |
| 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 | 306 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 34 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 28 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.3209 |