| National Provider Identifier [NPI]: | 1245455179 |
| Last Name Of The Provider | BERNEY |
| First Name Of The Provider | BERTRAM |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 181 NE 102ND AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | PORTLAND |
| Zip Code Of The Provider | 972204169 |
| State Code Of The Provider | OR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 38 |
| Number Of Services | 929.5 |
| Number Of Medicare Beneficiaries | 115 |
| Total Submitted Charge Amount | 130353 |
| Total Medicare Allowed Amount | 53686.11 |
| Total Medicare Payment Amount | 36209.05 |
| Total Medicare Standardized Payment Amount | 36956.83 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 105.5 |
| Number Of Medicare Beneficiaries With Drug Services | 51 |
| Total Drug Submitted ChargeAmount | 3014 |
| Total Drug Medicare AllowedAmount | 574.53 |
| Total Drug Medicare PaymentAmount | 532.85 |
| Total Drug Medicare Standardized Payment Amount | 532.85 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 32 |
| Number Of Medical Services | 824 |
| Number Of Medicare Beneficiaries With Medical Services | 115 |
| Total Medical Submitted Charge Amount | 127339 |
| Total Medical Medicare Allowed Amount | 53111.58 |
| Total Medical Medicare Payment Amount | 35676.2 |
| Total Medical Medicare Standardized Payment Amount | 36423.98 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 11 |
| Number Of Beneficiaries Age 65 to 74 | 50 |
| Number Of Beneficiaries Age 75 to 84 | 34 |
| Number Of Beneficiaries Age Greater 84 | 20 |
| Number Of Female Beneficiaries | 55 |
| Number Of Male Beneficiaries | 60 |
| Number Of Non Hispanic White Beneficiaries | 104 |
| 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 | 0 |
| Number Of Beneficiaries With Medicare Only Entitlement | 103 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 12 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 29 |
| Percent Of With Hypertension | 50 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 23 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0293 |