| National Provider Identifier [NPI]: | 1023170669 |
| Last Name Of The Provider | BERSON |
| First Name Of The Provider | MARC |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | O.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2804 WALBERT AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | ALLENTOWN |
| Zip Code Of The Provider | 181042400 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Optometry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 13 |
| Number Of Services | 321 |
| Number Of Medicare Beneficiaries | 193 |
| Total Submitted Charge Amount | 41349 |
| Total Medicare Allowed Amount | 29383.59 |
| Total Medicare Payment Amount | 21384.25 |
| Total Medicare Standardized Payment Amount | 22435.29 |
| 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 | 13 |
| Number Of Medical Services | 321 |
| Number Of Medicare Beneficiaries With Medical Services | 193 |
| Total Medical Submitted Charge Amount | 41349 |
| Total Medical Medicare Allowed Amount | 29383.59 |
| Total Medical Medicare Payment Amount | 21384.25 |
| Total Medical Medicare Standardized Payment Amount | 22435.29 |
| Average Age Of Beneficiaries | 64 |
| Number Of Beneficiaries Age Less65 | 73 |
| Number Of Beneficiaries Age 65 to 74 | 68 |
| Number Of Beneficiaries Age 75 to 84 | 36 |
| Number Of Beneficiaries Age Greater 84 | 16 |
| Number Of Female Beneficiaries | 97 |
| Number Of Male Beneficiaries | 96 |
| Number Of Non Hispanic White Beneficiaries | 161 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 15 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 101 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 92 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 7 |
| Percent Of With Chronic Kidney Disease | 10 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 55 |
| Percent Of With Ischemic Heart Disease | 16 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 14 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0934 |