| National Provider Identifier [NPI]: | 1205925682 |
| Last Name Of The Provider | SODERBERG |
| First Name Of The Provider | BECK |
| 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 | 139 BERKELEY RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | DEVON |
| Zip Code Of The Provider | 193331544 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 24 |
| Number Of Services | 870 |
| Number Of Medicare Beneficiaries | 258 |
| Total Submitted Charge Amount | 77535 |
| Total Medicare Allowed Amount | 63093.27 |
| Total Medicare Payment Amount | 47759.21 |
| Total Medicare Standardized Payment Amount | 45313.08 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 125 |
| Number Of Medicare Beneficiaries With Drug Services | 100 |
| Total Drug Submitted ChargeAmount | 5060 |
| Total Drug Medicare AllowedAmount | 4320.11 |
| Total Drug Medicare PaymentAmount | 4226.14 |
| Total Drug Medicare Standardized Payment Amount | 4226.14 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 18 |
| Number Of Medical Services | 745 |
| Number Of Medicare Beneficiaries With Medical Services | 258 |
| Total Medical Submitted Charge Amount | 72475 |
| Total Medical Medicare Allowed Amount | 58773.16 |
| Total Medical Medicare Payment Amount | 43533.07 |
| Total Medical Medicare Standardized Payment Amount | 41086.94 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 138 |
| Number Of Beneficiaries Age 75 to 84 | 80 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 139 |
| Number Of Male Beneficiaries | 119 |
| Number Of Non Hispanic White Beneficiaries | 242 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 16 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 48 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 0.9135 |