| National Provider Identifier [NPI]: | 1730168006 |
| Last Name Of The Provider | BERG |
| First Name Of The Provider | WILLIAM |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2025 SOQUEL AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | SANTA CRUZ |
| Zip Code Of The Provider | 950621323 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 105 |
| Number Of Services | 6440 |
| Number Of Medicare Beneficiaries | 3102 |
| Total Submitted Charge Amount | 1822561 |
| Total Medicare Allowed Amount | 489577.67 |
| Total Medicare Payment Amount | 418805 |
| Total Medicare Standardized Payment Amount | 393307.92 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 655 |
| Number Of Medicare Beneficiaries With Drug Services | 30 |
| Total Drug Submitted ChargeAmount | 3050 |
| Total Drug Medicare AllowedAmount | 1174.94 |
| Total Drug Medicare PaymentAmount | 910.24 |
| Total Drug Medicare Standardized Payment Amount | 910.24 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 103 |
| Number Of Medical Services | 5785 |
| Number Of Medicare Beneficiaries With Medical Services | 3102 |
| Total Medical Submitted Charge Amount | 1819511 |
| Total Medical Medicare Allowed Amount | 488402.73 |
| Total Medical Medicare Payment Amount | 417894.76 |
| Total Medical Medicare Standardized Payment Amount | 392397.68 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 263 |
| Number Of Beneficiaries Age 65 to 74 | 1777 |
| Number Of Beneficiaries Age 75 to 84 | 782 |
| Number Of Beneficiaries Age Greater 84 | 280 |
| Number Of Female Beneficiaries | 2567 |
| Number Of Male Beneficiaries | 535 |
| Number Of Non Hispanic White Beneficiaries | 2727 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 67 |
| Number Of Hispanic Beneficiaries | 220 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 63 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2772 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 330 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 16 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 45 |
| Percent Of With Ischemic Heart Disease | 16 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.8592 |