| National Provider Identifier [NPI]: | 1811994858 |
| Last Name Of The Provider | BERENS |
| First Name Of The Provider | BRUCE |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M. D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 166 4TH ST E |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAINT PAUL |
| Zip Code Of The Provider | 551011421 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 91 |
| Number Of Services | 3168 |
| Number Of Medicare Beneficiaries | 1892 |
| Total Submitted Charge Amount | 257955.23 |
| Total Medicare Allowed Amount | 84336.54 |
| Total Medicare Payment Amount | 63123.57 |
| Total Medicare Standardized Payment Amount | 65836.51 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 91 |
| Number Of Medical Services | 3168 |
| Number Of Medicare Beneficiaries With Medical Services | 1892 |
| Total Medical Submitted Charge Amount | 257955.23 |
| Total Medical Medicare Allowed Amount | 84336.54 |
| Total Medical Medicare Payment Amount | 63123.57 |
| Total Medical Medicare Standardized Payment Amount | 65836.51 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 675 |
| Number Of Beneficiaries Age 65 to 74 | 446 |
| Number Of Beneficiaries Age 75 to 84 | 422 |
| Number Of Beneficiaries Age Greater 84 | 349 |
| Number Of Female Beneficiaries | 1023 |
| Number Of Male Beneficiaries | 869 |
| Number Of Non Hispanic White Beneficiaries | 1529 |
| Number Of Black or African American Beneficiaries | 208 |
| Number Of AsianPacific Islander Beneficiaries | 54 |
| Number Of Hispanic Beneficiaries | 53 |
| Number Of American Indian Alaska Native Beneficiaries | 24 |
| Number Of Beneficiaries With Race Not Else where Classified | 24 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1103 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 789 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 43 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 14 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.8997 |