| National Provider Identifier [NPI]: | 1992817142 |
| Last Name Of The Provider | BERG |
| First Name Of The Provider | CHRISTINE |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 14712 VICTOR HUGO BLVD N |
| Street Address 2 Of The Provider | |
| City Of The Provider | HUGO |
| Zip Code Of The Provider | 550386419 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 35 |
| Number Of Services | 235 |
| Number Of Medicare Beneficiaries | 50 |
| Total Submitted Charge Amount | 22749.54 |
| Total Medicare Allowed Amount | 9916.67 |
| Total Medicare Payment Amount | 6784.8 |
| Total Medicare Standardized Payment Amount | 7706.14 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 27 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 306.04 |
| Total Drug Medicare AllowedAmount | 247.47 |
| Total Drug Medicare PaymentAmount | 237.62 |
| Total Drug Medicare Standardized Payment Amount | 237.62 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 30 |
| Number Of Medical Services | 208 |
| Number Of Medicare Beneficiaries With Medical Services | 50 |
| Total Medical Submitted Charge Amount | 22443.5 |
| Total Medical Medicare Allowed Amount | 9669.2 |
| Total Medical Medicare Payment Amount | 6547.18 |
| Total Medical Medicare Standardized Payment Amount | 7468.52 |
| Average Age Of Beneficiaries | 63 |
| Number Of Beneficiaries Age Less65 | 26 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 36 |
| Number Of Male Beneficiaries | 14 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 29 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 21 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | |
| Percent Of With Hyperlipidemia | 26 |
| Percent Of With Hypertension | 34 |
| Percent Of With Ischemic Heart Disease | |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2048 |