| National Provider Identifier [NPI]: | 1275707606 |
| Last Name Of The Provider | BERRY |
| First Name Of The Provider | EMILY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 250 E SUPERIOR ST |
| Street Address 2 Of The Provider | SUITE 05-2168 |
| City Of The Provider | CHICAGO |
| Zip Code Of The Provider | 606112914 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Gynecological/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 112 |
| Number Of Services | 24137 |
| Number Of Medicare Beneficiaries | 250 |
| Total Submitted Charge Amount | 1821967 |
| Total Medicare Allowed Amount | 412301.76 |
| Total Medicare Payment Amount | 319102.12 |
| Total Medicare Standardized Payment Amount | 311211.16 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 49 |
| Number Of Drug Services | 22345 |
| Number Of Medicare Beneficiaries With Drug Services | 98 |
| Total Drug Submitted ChargeAmount | 1231875 |
| Total Drug Medicare AllowedAmount | 286554.57 |
| Total Drug Medicare PaymentAmount | 222509.13 |
| Total Drug Medicare Standardized Payment Amount | 222509.13 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 63 |
| Number Of Medical Services | 1792 |
| Number Of Medicare Beneficiaries With Medical Services | 247 |
| Total Medical Submitted Charge Amount | 590092 |
| Total Medical Medicare Allowed Amount | 125747.19 |
| Total Medical Medicare Payment Amount | 96592.99 |
| Total Medical Medicare Standardized Payment Amount | 88702.03 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 42 |
| Number Of Beneficiaries Age 65 to 74 | 131 |
| Number Of Beneficiaries Age 75 to 84 | 62 |
| Number Of Beneficiaries Age Greater 84 | 15 |
| Number Of Female Beneficiaries | |
| Number Of Male Beneficiaries | |
| Number Of Non Hispanic White Beneficiaries | 178 |
| Number Of Black or African American Beneficiaries | 40 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 18 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 203 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 47 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 23 |
| Percent Of With Heart Failure | 7 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 17 |
| Percent Of With Hyperlipidemia | 38 |
| Percent Of With Hypertension | 48 |
| Percent Of With Ischemic Heart Disease | 12 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 29 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.6267 |