National Provider Identifier [NPI]: |
1235196858 |
Last Name Of The Provider |
BERK |
First Name Of The Provider |
MARK |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
900 N WESTMORELAND RD |
Street Address 2 Of The Provider |
SUITE 222 |
City Of The Provider |
LAKE FOREST |
Zip Code Of The Provider |
600451674 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
91 |
Number Of Services |
11945 |
Number Of Medicare Beneficiaries |
1841 |
Total Submitted Charge Amount |
1399130 |
Total Medicare Allowed Amount |
729437.55 |
Total Medicare Payment Amount |
524433.6 |
Total Medicare Standardized Payment Amount |
493528.26 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
484 |
Number Of Medicare Beneficiaries With Drug Services |
121 |
Total Drug Submitted ChargeAmount |
7830 |
Total Drug Medicare AllowedAmount |
1359.27 |
Total Drug Medicare PaymentAmount |
982.85 |
Total Drug Medicare Standardized Payment Amount |
982.85 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
89 |
Number Of Medical Services |
11461 |
Number Of Medicare Beneficiaries With Medical Services |
1841 |
Total Medical Submitted Charge Amount |
1391300 |
Total Medical Medicare Allowed Amount |
728078.28 |
Total Medical Medicare Payment Amount |
523450.75 |
Total Medical Medicare Standardized Payment Amount |
492545.41 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
179 |
Number Of Beneficiaries Age 65 to 74 |
891 |
Number Of Beneficiaries Age 75 to 84 |
538 |
Number Of Beneficiaries Age Greater 84 |
233 |
Number Of Female Beneficiaries |
929 |
Number Of Male Beneficiaries |
912 |
Number Of Non Hispanic White Beneficiaries |
1572 |
Number Of Black or African American Beneficiaries |
62 |
Number Of AsianPacific Islander Beneficiaries |
36 |
Number Of Hispanic Beneficiaries |
139 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
32 |
Number Of Beneficiaries With Medicare Only Entitlement |
1543 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
298 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
55 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.0155 |