| National Provider Identifier [NPI]: | 1285737106 |
| Last Name Of The Provider | BERG |
| First Name Of The Provider | PETER |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 762 WEST 4TH STREET |
| Street Address 2 Of The Provider | |
| City Of The Provider | RUSH CITY |
| Zip Code Of The Provider | 55069 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 63 |
| Number Of Services | 939 |
| Number Of Medicare Beneficiaries | 154 |
| Total Submitted Charge Amount | 76222.76 |
| Total Medicare Allowed Amount | 33207.09 |
| Total Medicare Payment Amount | 22974.97 |
| Total Medicare Standardized Payment Amount | 23699.06 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 407 |
| Number Of Medicare Beneficiaries With Drug Services | 31 |
| Total Drug Submitted ChargeAmount | 5560.26 |
| Total Drug Medicare AllowedAmount | 3435.29 |
| Total Drug Medicare PaymentAmount | 2828.52 |
| Total Drug Medicare Standardized Payment Amount | 2828.52 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 55 |
| Number Of Medical Services | 532 |
| Number Of Medicare Beneficiaries With Medical Services | 153 |
| Total Medical Submitted Charge Amount | 70662.5 |
| Total Medical Medicare Allowed Amount | 29771.8 |
| Total Medical Medicare Payment Amount | 20146.45 |
| Total Medical Medicare Standardized Payment Amount | 20870.54 |
| Average Age Of Beneficiaries | 64 |
| Number Of Beneficiaries Age Less65 | 61 |
| Number Of Beneficiaries Age 65 to 74 | 35 |
| Number Of Beneficiaries Age 75 to 84 | 43 |
| Number Of Beneficiaries Age Greater 84 | 15 |
| Number Of Female Beneficiaries | 53 |
| Number Of Male Beneficiaries | 101 |
| 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 | 92 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 62 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 35 |
| Percent Of With Hypertension | 53 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 22 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 15 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9981 |