| National Provider Identifier [NPI]: | 1710065230 |
| Last Name Of The Provider | BERRY |
| First Name Of The Provider | BRUCE |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2025 W OKLAHOMA AVE |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | MILWAUKEE |
| Zip Code Of The Provider | 53216 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 36 |
| Number Of Services | 2718 |
| Number Of Medicare Beneficiaries | 618 |
| Total Submitted Charge Amount | 433849 |
| Total Medicare Allowed Amount | 233508.83 |
| Total Medicare Payment Amount | 172171 |
| Total Medicare Standardized Payment Amount | 179592.68 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 269 |
| Number Of Medicare Beneficiaries With Drug Services | 169 |
| Total Drug Submitted ChargeAmount | 6222 |
| Total Drug Medicare AllowedAmount | 4156.99 |
| Total Drug Medicare PaymentAmount | 4009.19 |
| Total Drug Medicare Standardized Payment Amount | 4009.19 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 2449 |
| Number Of Medicare Beneficiaries With Medical Services | 618 |
| Total Medical Submitted Charge Amount | 427627 |
| Total Medical Medicare Allowed Amount | 229351.84 |
| Total Medical Medicare Payment Amount | 168161.81 |
| Total Medical Medicare Standardized Payment Amount | 175583.49 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 27 |
| Number Of Beneficiaries Age 65 to 74 | 211 |
| Number Of Beneficiaries Age 75 to 84 | 237 |
| Number Of Beneficiaries Age Greater 84 | 143 |
| Number Of Female Beneficiaries | 373 |
| Number Of Male Beneficiaries | 245 |
| Number Of Non Hispanic White Beneficiaries | 583 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 16 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 577 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 41 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.1081 |