| National Provider Identifier [NPI]: | 1710963517 |
| Last Name Of The Provider | BERBOS |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 301 SADDLE DR |
| Street Address 2 Of The Provider | SUITE B |
| City Of The Provider | HELENA |
| Zip Code Of The Provider | 59601 |
| State Code Of The Provider | MT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 52 |
| Number Of Services | 4502 |
| Number Of Medicare Beneficiaries | 1216 |
| Total Submitted Charge Amount | 1189789 |
| Total Medicare Allowed Amount | 594664.38 |
| Total Medicare Payment Amount | 429807.06 |
| Total Medicare Standardized Payment Amount | 430125.47 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 574 |
| Number Of Medicare Beneficiaries With Drug Services | 59 |
| Total Drug Submitted ChargeAmount | 223905 |
| Total Drug Medicare AllowedAmount | 166820.83 |
| Total Drug Medicare PaymentAmount | 129475.69 |
| Total Drug Medicare Standardized Payment Amount | 129475.69 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 48 |
| Number Of Medical Services | 3928 |
| Number Of Medicare Beneficiaries With Medical Services | 1216 |
| Total Medical Submitted Charge Amount | 965884 |
| Total Medical Medicare Allowed Amount | 427843.55 |
| Total Medical Medicare Payment Amount | 300331.37 |
| Total Medical Medicare Standardized Payment Amount | 300649.78 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 90 |
| Number Of Beneficiaries Age 65 to 74 | 594 |
| Number Of Beneficiaries Age 75 to 84 | 342 |
| Number Of Beneficiaries Age Greater 84 | 190 |
| Number Of Female Beneficiaries | 734 |
| Number Of Male Beneficiaries | 482 |
| Number Of Non Hispanic White Beneficiaries | 1168 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 12 |
| Number Of Beneficiaries With Race Not Else where Classified | 23 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1092 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 124 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 30 |
| Percent Of With Hypertension | 43 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 2 |
| Average HCC Risk Score Of Beneficiaries | 0.9844 |