National Provider Identifier [NPI]: |
1417037409 |
Last Name Of The Provider |
BERG |
First Name Of The Provider |
PAUL |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3201 S AUSTIN AVE STE 2110 |
Street Address 2 Of The Provider |
|
City Of The Provider |
GEORGETOWN |
Zip Code Of The Provider |
786267537 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
814 |
Number Of Medicare Beneficiaries |
346 |
Total Submitted Charge Amount |
160630 |
Total Medicare Allowed Amount |
58630.57 |
Total Medicare Payment Amount |
36692.95 |
Total Medicare Standardized Payment Amount |
39803.25 |
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 |
13 |
Number Of Medical Services |
814 |
Number Of Medicare Beneficiaries With Medical Services |
346 |
Total Medical Submitted Charge Amount |
160630 |
Total Medical Medicare Allowed Amount |
58630.57 |
Total Medical Medicare Payment Amount |
36692.95 |
Total Medical Medicare Standardized Payment Amount |
39803.25 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
38 |
Number Of Beneficiaries Age 65 to 74 |
185 |
Number Of Beneficiaries Age 75 to 84 |
104 |
Number Of Beneficiaries Age Greater 84 |
19 |
Number Of Female Beneficiaries |
156 |
Number Of Male Beneficiaries |
190 |
Number Of Non Hispanic White Beneficiaries |
308 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
23 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
317 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
29 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
12 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
53 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
0.7899 |