National Provider Identifier [NPI]: |
1962490813 |
Last Name Of The Provider |
BERST |
First Name Of The Provider |
MATTHEW |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
615 VALLEY VIEW DR |
Street Address 2 Of The Provider |
SUITE 202 |
City Of The Provider |
MOLINE |
Zip Code Of The Provider |
612656150 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
206 |
Number Of Services |
5636 |
Number Of Medicare Beneficiaries |
3683 |
Total Submitted Charge Amount |
627350.26 |
Total Medicare Allowed Amount |
180507.08 |
Total Medicare Payment Amount |
140707.07 |
Total Medicare Standardized Payment Amount |
147213.97 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
132 |
Number Of Medicare Beneficiaries With Drug Services |
28 |
Total Drug Submitted ChargeAmount |
942.9 |
Total Drug Medicare AllowedAmount |
259.94 |
Total Drug Medicare PaymentAmount |
201 |
Total Drug Medicare Standardized Payment Amount |
201 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
205 |
Number Of Medical Services |
5504 |
Number Of Medicare Beneficiaries With Medical Services |
3683 |
Total Medical Submitted Charge Amount |
626407.36 |
Total Medical Medicare Allowed Amount |
180247.14 |
Total Medical Medicare Payment Amount |
140506.07 |
Total Medical Medicare Standardized Payment Amount |
147012.97 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
613 |
Number Of Beneficiaries Age 65 to 74 |
1458 |
Number Of Beneficiaries Age 75 to 84 |
1029 |
Number Of Beneficiaries Age Greater 84 |
583 |
Number Of Female Beneficiaries |
2339 |
Number Of Male Beneficiaries |
1344 |
Number Of Non Hispanic White Beneficiaries |
3367 |
Number Of Black or African American Beneficiaries |
167 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
104 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
31 |
Number Of Beneficiaries With Medicare Only Entitlement |
2876 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
807 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.4105 |