| National Provider Identifier [NPI]: | 1891749776 |
| Last Name Of The Provider | BERGGRUEN |
| First Name Of The Provider | SENTA |
| 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 | 201 E HURON ST |
| Street Address 2 Of The Provider | 4TH FLOOR |
| City Of The Provider | CHICAGO |
| Zip Code Of The Provider | 606113197 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 69 |
| Number Of Services | 1931 |
| Number Of Medicare Beneficiaries | 1438 |
| Total Submitted Charge Amount | 663011 |
| Total Medicare Allowed Amount | 125506.33 |
| Total Medicare Payment Amount | 93232.47 |
| Total Medicare Standardized Payment Amount | 88341.01 |
| 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 | 69 |
| Number Of Medical Services | 1931 |
| Number Of Medicare Beneficiaries With Medical Services | 1438 |
| Total Medical Submitted Charge Amount | 663011 |
| Total Medical Medicare Allowed Amount | 125506.33 |
| Total Medical Medicare Payment Amount | 93232.47 |
| Total Medical Medicare Standardized Payment Amount | 88341.01 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 278 |
| Number Of Beneficiaries Age 65 to 74 | 646 |
| Number Of Beneficiaries Age 75 to 84 | 379 |
| Number Of Beneficiaries Age Greater 84 | 135 |
| Number Of Female Beneficiaries | 730 |
| Number Of Male Beneficiaries | 708 |
| Number Of Non Hispanic White Beneficiaries | 933 |
| Number Of Black or African American Beneficiaries | 321 |
| Number Of AsianPacific Islander Beneficiaries | 42 |
| Number Of Hispanic Beneficiaries | 104 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 38 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1079 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 359 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 22 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.9234 |