National Provider Identifier [NPI]: |
1760591689 |
Last Name Of The Provider |
BERG |
First Name Of The Provider |
NAHLA |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
800 W RANDOL MILL RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
ARLINGTON |
Zip Code Of The Provider |
760122504 |
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 |
26 |
Number Of Services |
738 |
Number Of Medicare Beneficiaries |
480 |
Total Submitted Charge Amount |
355012 |
Total Medicare Allowed Amount |
78242.9 |
Total Medicare Payment Amount |
59415.63 |
Total Medicare Standardized Payment Amount |
60301.53 |
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 |
26 |
Number Of Medical Services |
738 |
Number Of Medicare Beneficiaries With Medical Services |
480 |
Total Medical Submitted Charge Amount |
355012 |
Total Medical Medicare Allowed Amount |
78242.9 |
Total Medical Medicare Payment Amount |
59415.63 |
Total Medical Medicare Standardized Payment Amount |
60301.53 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
135 |
Number Of Beneficiaries Age 65 to 74 |
136 |
Number Of Beneficiaries Age 75 to 84 |
115 |
Number Of Beneficiaries Age Greater 84 |
94 |
Number Of Female Beneficiaries |
283 |
Number Of Male Beneficiaries |
197 |
Number Of Non Hispanic White Beneficiaries |
334 |
Number Of Black or African American Beneficiaries |
89 |
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 |
310 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
170 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
28 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
43 |
Percent Of With Chronic Kidney Disease |
49 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
52 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
2.4507 |