| National Provider Identifier [NPI]: | 1821000456 |
| Last Name Of The Provider | BERGSTROM |
| First Name Of The Provider | RECHA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 795 EL CAMINO REAL |
| Street Address 2 Of The Provider | |
| City Of The Provider | PALO ALTO |
| Zip Code Of The Provider | 943012302 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 145 |
| Number Of Services | 11290 |
| Number Of Medicare Beneficiaries | 1827 |
| Total Submitted Charge Amount | 1217559 |
| Total Medicare Allowed Amount | 367926.31 |
| Total Medicare Payment Amount | 309914.59 |
| Total Medicare Standardized Payment Amount | 248071.27 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 8036 |
| Number Of Medicare Beneficiaries With Drug Services | 85 |
| Total Drug Submitted ChargeAmount | 12410 |
| Total Drug Medicare AllowedAmount | 3068.33 |
| Total Drug Medicare PaymentAmount | 2405.37 |
| Total Drug Medicare Standardized Payment Amount | 2405.37 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 138 |
| Number Of Medical Services | 3254 |
| Number Of Medicare Beneficiaries With Medical Services | 1827 |
| Total Medical Submitted Charge Amount | 1205149 |
| Total Medical Medicare Allowed Amount | 364857.98 |
| Total Medical Medicare Payment Amount | 307509.22 |
| Total Medical Medicare Standardized Payment Amount | 245665.9 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 104 |
| Number Of Beneficiaries Age 65 to 74 | 1082 |
| Number Of Beneficiaries Age 75 to 84 | 494 |
| Number Of Beneficiaries Age Greater 84 | 147 |
| Number Of Female Beneficiaries | 1490 |
| Number Of Male Beneficiaries | 337 |
| Number Of Non Hispanic White Beneficiaries | 1265 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 320 |
| Number Of Hispanic Beneficiaries | 107 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 77 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1594 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 233 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 7 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 18 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 46 |
| Percent Of With Ischemic Heart Disease | 15 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 2 |
| Average HCC Risk Score Of Beneficiaries | 0.8425 |