National Provider Identifier [NPI]: |
1093766446 |
Last Name Of The Provider |
BERGER |
First Name Of The Provider |
BERTRAND |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
PHD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1155 N MAYFAIR RD |
Street Address 2 Of The Provider |
DEPARTMENT OF PSYCHIATRY |
City Of The Provider |
MILWAUKEE |
Zip Code Of The Provider |
532263462 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Clinical Psychologist |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
3 |
Number Of Services |
183 |
Number Of Medicare Beneficiaries |
112 |
Total Submitted Charge Amount |
73230 |
Total Medicare Allowed Amount |
18668.02 |
Total Medicare Payment Amount |
14509.34 |
Total Medicare Standardized Payment Amount |
14802.32 |
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 |
3 |
Number Of Medical Services |
183 |
Number Of Medicare Beneficiaries With Medical Services |
112 |
Total Medical Submitted Charge Amount |
73230 |
Total Medical Medicare Allowed Amount |
18668.02 |
Total Medical Medicare Payment Amount |
14509.34 |
Total Medical Medicare Standardized Payment Amount |
14802.32 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
11 |
Number Of Beneficiaries Age 65 to 74 |
30 |
Number Of Beneficiaries Age 75 to 84 |
37 |
Number Of Beneficiaries Age Greater 84 |
34 |
Number Of Female Beneficiaries |
51 |
Number Of Male Beneficiaries |
61 |
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 |
20 |
Percent Of With Atrial Fibrillation |
34 |
Percent Of With Alzheimers Disease or Dementia |
29 |
Percent Of With Asthma |
23 |
Percent Of With Cancer |
20 |
Percent Of With Heart Failure |
54 |
Percent Of With Chronic Kidney Disease |
59 |
Percent Of With Chronic Obstructive Pulmonary Disease |
36 |
Percent Of With Depression |
51 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
63 |
Percent Of With Osteoporosis |
20 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
62 |
Percent Of With Schizophrenia Other PsychoticDisorders |
20 |
Percent Of With Stroke |
28 |
Average HCC Risk Score Of Beneficiaries |
2.0898 |