| National Provider Identifier [NPI]: | 1962481747 |
| Last Name Of The Provider | BERGER |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | MD |
| 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 | 156 |
| Number Of Services | 8139 |
| Number Of Medicare Beneficiaries | 2788 |
| Total Submitted Charge Amount | 405912.98 |
| Total Medicare Allowed Amount | 131151.91 |
| Total Medicare Payment Amount | 100394.11 |
| Total Medicare Standardized Payment Amount | 105136.15 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 4185 |
| Number Of Medicare Beneficiaries With Drug Services | 33 |
| Total Drug Submitted ChargeAmount | 6215 |
| Total Drug Medicare AllowedAmount | 772.14 |
| Total Drug Medicare PaymentAmount | 605.36 |
| Total Drug Medicare Standardized Payment Amount | 605.36 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 155 |
| Number Of Medical Services | 3954 |
| Number Of Medicare Beneficiaries With Medical Services | 2788 |
| Total Medical Submitted Charge Amount | 399697.98 |
| Total Medical Medicare Allowed Amount | 130379.77 |
| Total Medical Medicare Payment Amount | 99788.75 |
| Total Medical Medicare Standardized Payment Amount | 104530.79 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 609 |
| Number Of Beneficiaries Age 65 to 74 | 869 |
| Number Of Beneficiaries Age 75 to 84 | 769 |
| Number Of Beneficiaries Age Greater 84 | 541 |
| Number Of Female Beneficiaries | 1718 |
| Number Of Male Beneficiaries | 1070 |
| Number Of Non Hispanic White Beneficiaries | 2513 |
| Number Of Black or African American Beneficiaries | 115 |
| Number Of AsianPacific Islander Beneficiaries | 57 |
| Number Of Hispanic Beneficiaries | 46 |
| Number Of American Indian Alaska Native Beneficiaries | 20 |
| Number Of Beneficiaries With Race Not Else where Classified | 37 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2138 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 650 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.5525 |