National Provider Identifier [NPI]: |
1205062262 |
Last Name Of The Provider |
BERG |
First Name Of The Provider |
KRISTIN |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
921 GESSNER RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
HOUSTON |
Zip Code Of The Provider |
770242501 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
36 |
Number Of Services |
955 |
Number Of Medicare Beneficiaries |
593 |
Total Submitted Charge Amount |
808193 |
Total Medicare Allowed Amount |
115780.48 |
Total Medicare Payment Amount |
89394.67 |
Total Medicare Standardized Payment Amount |
88810.69 |
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 |
36 |
Number Of Medical Services |
955 |
Number Of Medicare Beneficiaries With Medical Services |
593 |
Total Medical Submitted Charge Amount |
808193 |
Total Medical Medicare Allowed Amount |
115780.48 |
Total Medical Medicare Payment Amount |
89394.67 |
Total Medical Medicare Standardized Payment Amount |
88810.69 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
172 |
Number Of Beneficiaries Age 65 to 74 |
167 |
Number Of Beneficiaries Age 75 to 84 |
160 |
Number Of Beneficiaries Age Greater 84 |
94 |
Number Of Female Beneficiaries |
374 |
Number Of Male Beneficiaries |
219 |
Number Of Non Hispanic White Beneficiaries |
317 |
Number Of Black or African American Beneficiaries |
161 |
Number Of AsianPacific Islander Beneficiaries |
|
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 |
361 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
232 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
35 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
50 |
Percent Of With Chronic Kidney Disease |
51 |
Percent Of With Chronic Obstructive Pulmonary Disease |
36 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
55 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
61 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
23 |
Average HCC Risk Score Of Beneficiaries |
2.9307 |