| National Provider Identifier [NPI]: | 1649589227 |
| Last Name Of The Provider | BERG |
| First Name Of The Provider | CAROLYN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9709 E 79TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | TULSA |
| Zip Code Of The Provider | 741334566 |
| State Code Of The Provider | OK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hand Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 103 |
| Number Of Services | 745 |
| Number Of Medicare Beneficiaries | 160 |
| Total Submitted Charge Amount | 224670 |
| Total Medicare Allowed Amount | 73266.4 |
| Total Medicare Payment Amount | 54727.34 |
| Total Medicare Standardized Payment Amount | 59527.86 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 136 |
| Number Of Medicare Beneficiaries With Drug Services | 39 |
| Total Drug Submitted ChargeAmount | 4286 |
| Total Drug Medicare AllowedAmount | 3705.91 |
| Total Drug Medicare PaymentAmount | 2890.19 |
| Total Drug Medicare Standardized Payment Amount | 2890.19 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 101 |
| Number Of Medical Services | 609 |
| Number Of Medicare Beneficiaries With Medical Services | 160 |
| Total Medical Submitted Charge Amount | 220384 |
| Total Medical Medicare Allowed Amount | 69560.49 |
| Total Medical Medicare Payment Amount | 51837.15 |
| Total Medical Medicare Standardized Payment Amount | 56637.67 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 18 |
| Number Of Beneficiaries Age 65 to 74 | 84 |
| Number Of Beneficiaries Age 75 to 84 | 47 |
| Number Of Beneficiaries Age Greater 84 | 11 |
| Number Of Female Beneficiaries | 95 |
| Number Of Male Beneficiaries | 65 |
| Number Of Non Hispanic White Beneficiaries | 143 |
| Number Of Black or African American Beneficiaries | |
| 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 | 148 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 12 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 58 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9382 |