| National Provider Identifier [NPI]: | 1629047659 |
| Last Name Of The Provider | BERG |
| First Name Of The Provider | STEPHANIE |
| 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 | 3388 MAIN ST STE 100 |
| Street Address 2 Of The Provider | |
| City Of The Provider | FRISCO |
| Zip Code Of The Provider | 750334553 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 52 |
| Number Of Services | 2382 |
| Number Of Medicare Beneficiaries | 252 |
| Total Submitted Charge Amount | 226630.52 |
| Total Medicare Allowed Amount | 99860.89 |
| Total Medicare Payment Amount | 73017.32 |
| Total Medicare Standardized Payment Amount | 77745.97 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 16 |
| Number Of Drug Services | 310 |
| Number Of Medicare Beneficiaries With Drug Services | 139 |
| Total Drug Submitted ChargeAmount | 13153.51 |
| Total Drug Medicare AllowedAmount | 3440.07 |
| Total Drug Medicare PaymentAmount | 3246.11 |
| Total Drug Medicare Standardized Payment Amount | 3246.11 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 36 |
| Number Of Medical Services | 2072 |
| Number Of Medicare Beneficiaries With Medical Services | 252 |
| Total Medical Submitted Charge Amount | 213477.01 |
| Total Medical Medicare Allowed Amount | 96420.82 |
| Total Medical Medicare Payment Amount | 69771.21 |
| Total Medical Medicare Standardized Payment Amount | 74499.86 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 17 |
| Number Of Beneficiaries Age 65 to 74 | 134 |
| Number Of Beneficiaries Age 75 to 84 | 72 |
| Number Of Beneficiaries Age Greater 84 | 29 |
| Number Of Female Beneficiaries | 183 |
| Number Of Male Beneficiaries | 69 |
| Number Of Non Hispanic White Beneficiaries | 224 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 235 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 17 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 0.9056 |