| National Provider Identifier [NPI]: | 1376506022 |
| Last Name Of The Provider | BERG |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1169 EASTERN PKWY |
| Street Address 2 Of The Provider | SUITE 2211 |
| City Of The Provider | LOUISVILLE |
| Zip Code Of The Provider | 402171444 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Interventional Pain Management |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 48 |
| Number Of Services | 12452 |
| Number Of Medicare Beneficiaries | 578 |
| Total Submitted Charge Amount | 1074476.25 |
| Total Medicare Allowed Amount | 385098.1 |
| Total Medicare Payment Amount | 276304.25 |
| Total Medicare Standardized Payment Amount | 304920.79 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 7047 |
| Number Of Medicare Beneficiaries With Drug Services | 430 |
| Total Drug Submitted ChargeAmount | 55846.25 |
| Total Drug Medicare AllowedAmount | 14371.87 |
| Total Drug Medicare PaymentAmount | 10218.97 |
| Total Drug Medicare Standardized Payment Amount | 10218.97 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 35 |
| Number Of Medical Services | 5405 |
| Number Of Medicare Beneficiaries With Medical Services | 578 |
| Total Medical Submitted Charge Amount | 1018630 |
| Total Medical Medicare Allowed Amount | 370726.23 |
| Total Medical Medicare Payment Amount | 266085.28 |
| Total Medical Medicare Standardized Payment Amount | 294701.82 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 216 |
| Number Of Beneficiaries Age 65 to 74 | 174 |
| Number Of Beneficiaries Age 75 to 84 | 154 |
| Number Of Beneficiaries Age Greater 84 | 34 |
| Number Of Female Beneficiaries | 397 |
| Number Of Male Beneficiaries | 181 |
| Number Of Non Hispanic White Beneficiaries | 520 |
| 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 | 447 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 131 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.2577 |