| National Provider Identifier [NPI]: | 1851385330 |
| Last Name Of The Provider | BERGEN |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3550 LUTHERAN PKWY |
| Street Address 2 Of The Provider | SUITE 100A |
| City Of The Provider | WHEAT RIDGE |
| Zip Code Of The Provider | 800336017 |
| State Code Of The Provider | CO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 19 |
| Number Of Services | 1259 |
| Number Of Medicare Beneficiaries | 285 |
| Total Submitted Charge Amount | 132685 |
| Total Medicare Allowed Amount | 119389.24 |
| Total Medicare Payment Amount | 88594.21 |
| Total Medicare Standardized Payment Amount | 89177.51 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 23 |
| Number Of Medicare Beneficiaries With Drug Services | 14 |
| Total Drug Submitted ChargeAmount | 154 |
| Total Drug Medicare AllowedAmount | 113.38 |
| Total Drug Medicare PaymentAmount | 104.72 |
| Total Drug Medicare Standardized Payment Amount | 104.72 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 16 |
| Number Of Medical Services | 1236 |
| Number Of Medicare Beneficiaries With Medical Services | 285 |
| Total Medical Submitted Charge Amount | 132531 |
| Total Medical Medicare Allowed Amount | 119275.86 |
| Total Medical Medicare Payment Amount | 88489.49 |
| Total Medical Medicare Standardized Payment Amount | 89072.79 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 46 |
| Number Of Beneficiaries Age 65 to 74 | 96 |
| Number Of Beneficiaries Age 75 to 84 | 97 |
| Number Of Beneficiaries Age Greater 84 | 46 |
| Number Of Female Beneficiaries | 165 |
| Number Of Male Beneficiaries | 120 |
| Number Of Non Hispanic White Beneficiaries | 248 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 22 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 248 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 37 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 40 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 42 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.8687 |