| National Provider Identifier [NPI]: | 1225096969 |
| Last Name Of The Provider | WIERSIG |
| First Name Of The Provider | JEREMY |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 18802 MEISNER DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAN ANTONIO |
| Zip Code Of The Provider | 78258 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 150 |
| Number Of Services | 11544 |
| Number Of Medicare Beneficiaries | 1272 |
| Total Submitted Charge Amount | 1668466 |
| Total Medicare Allowed Amount | 326845.73 |
| Total Medicare Payment Amount | 253404.24 |
| Total Medicare Standardized Payment Amount | 271816.86 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 9420 |
| Number Of Medicare Beneficiaries With Drug Services | 168 |
| Total Drug Submitted ChargeAmount | 53240 |
| Total Drug Medicare AllowedAmount | 4185.7 |
| Total Drug Medicare PaymentAmount | 3216 |
| Total Drug Medicare Standardized Payment Amount | 3216 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 144 |
| Number Of Medical Services | 2124 |
| Number Of Medicare Beneficiaries With Medical Services | 1271 |
| Total Medical Submitted Charge Amount | 1615226 |
| Total Medical Medicare Allowed Amount | 322660.03 |
| Total Medical Medicare Payment Amount | 250188.24 |
| Total Medical Medicare Standardized Payment Amount | 268600.86 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 160 |
| Number Of Beneficiaries Age 65 to 74 | 696 |
| Number Of Beneficiaries Age 75 to 84 | 327 |
| Number Of Beneficiaries Age Greater 84 | 89 |
| Number Of Female Beneficiaries | 792 |
| Number Of Male Beneficiaries | 480 |
| Number Of Non Hispanic White Beneficiaries | 939 |
| Number Of Black or African American Beneficiaries | 50 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 262 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1149 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 123 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 23 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.4011 |