National Provider Identifier [NPI]: |
1740272061 |
Last Name Of The Provider |
BERGMAN |
First Name Of The Provider |
GARY |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
29990 NORTHWESTERN HWY |
Street Address 2 Of The Provider |
|
City Of The Provider |
FARMINGTON HILLS |
Zip Code Of The Provider |
483343225 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
579 |
Number Of Medicare Beneficiaries |
247 |
Total Submitted Charge Amount |
82905 |
Total Medicare Allowed Amount |
55002.3 |
Total Medicare Payment Amount |
38402.03 |
Total Medicare Standardized Payment Amount |
38783.36 |
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 |
13 |
Number Of Medical Services |
579 |
Number Of Medicare Beneficiaries With Medical Services |
247 |
Total Medical Submitted Charge Amount |
82905 |
Total Medical Medicare Allowed Amount |
55002.3 |
Total Medical Medicare Payment Amount |
38402.03 |
Total Medical Medicare Standardized Payment Amount |
38783.36 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
11 |
Number Of Beneficiaries Age 65 to 74 |
103 |
Number Of Beneficiaries Age 75 to 84 |
96 |
Number Of Beneficiaries Age Greater 84 |
37 |
Number Of Female Beneficiaries |
155 |
Number Of Male Beneficiaries |
92 |
Number Of Non Hispanic White Beneficiaries |
192 |
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 |
229 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
18 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.0354 |