| National Provider Identifier [NPI]: | 1083698997 |
| Last Name Of The Provider | BERG |
| First Name Of The Provider | GARY |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 27483 DEQUINDRE RD |
| Street Address 2 Of The Provider | SUITE 210 |
| City Of The Provider | MADISON HEIGHTS |
| Zip Code Of The Provider | 480713491 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 19 |
| Number Of Services | 649 |
| Number Of Medicare Beneficiaries | 207 |
| Total Submitted Charge Amount | 63609 |
| Total Medicare Allowed Amount | 52013.94 |
| Total Medicare Payment Amount | 39826.71 |
| Total Medicare Standardized Payment Amount | 38566.01 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 86 |
| Number Of Medicare Beneficiaries With Drug Services | 26 |
| Total Drug Submitted ChargeAmount | 1184 |
| Total Drug Medicare AllowedAmount | 301.71 |
| Total Drug Medicare PaymentAmount | 293.67 |
| Total Drug Medicare Standardized Payment Amount | 293.67 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 17 |
| Number Of Medical Services | 563 |
| Number Of Medicare Beneficiaries With Medical Services | 207 |
| Total Medical Submitted Charge Amount | 62425 |
| Total Medical Medicare Allowed Amount | 51712.23 |
| Total Medical Medicare Payment Amount | 39533.04 |
| Total Medical Medicare Standardized Payment Amount | 38272.34 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 63 |
| Number Of Beneficiaries Age 65 to 74 | 59 |
| Number Of Beneficiaries Age 75 to 84 | 60 |
| Number Of Beneficiaries Age Greater 84 | 25 |
| Number Of Female Beneficiaries | 115 |
| Number Of Male Beneficiaries | 92 |
| Number Of Non Hispanic White Beneficiaries | 165 |
| Number Of Black or African American Beneficiaries | 30 |
| 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 | 113 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 94 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 27 |
| Percent Of With Asthma | 33 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 59 |
| Percent Of With Chronic Kidney Disease | 48 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 73 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 60 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 73 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.9567 |