| National Provider Identifier [NPI]: | 1194707968 |
| Last Name Of The Provider | BERRIDGE |
| First Name Of The Provider | DEBRA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 500 W BROWN DEER RD |
| Street Address 2 Of The Provider | SUITE 202 |
| City Of The Provider | BAYSIDE |
| Zip Code Of The Provider | 532171618 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 99 |
| Number Of Services | 3346 |
| Number Of Medicare Beneficiaries | 2032 |
| Total Submitted Charge Amount | 451853 |
| Total Medicare Allowed Amount | 87458.34 |
| Total Medicare Payment Amount | 74526.59 |
| Total Medicare Standardized Payment Amount | 77614.34 |
| 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 | 99 |
| Number Of Medical Services | 3346 |
| Number Of Medicare Beneficiaries With Medical Services | 2032 |
| Total Medical Submitted Charge Amount | 451853 |
| Total Medical Medicare Allowed Amount | 87458.34 |
| Total Medical Medicare Payment Amount | 74526.59 |
| Total Medical Medicare Standardized Payment Amount | 77614.34 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 282 |
| Number Of Beneficiaries Age 65 to 74 | 824 |
| Number Of Beneficiaries Age 75 to 84 | 591 |
| Number Of Beneficiaries Age Greater 84 | 335 |
| Number Of Female Beneficiaries | 1602 |
| Number Of Male Beneficiaries | 430 |
| Number Of Non Hispanic White Beneficiaries | 1579 |
| Number Of Black or African American Beneficiaries | 349 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 52 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 32 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1595 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 437 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.2957 |