National Provider Identifier [NPI]: |
1659437572 |
Last Name Of The Provider |
BERGMAN |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
211 PARK ST |
Street Address 2 Of The Provider |
STURDY HOSP |
City Of The Provider |
ATTLEBORO |
Zip Code Of The Provider |
02703 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Infectious Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
8 |
Number Of Services |
780 |
Number Of Medicare Beneficiaries |
453 |
Total Submitted Charge Amount |
210210 |
Total Medicare Allowed Amount |
131252.39 |
Total Medicare Payment Amount |
102547.72 |
Total Medicare Standardized Payment Amount |
101061.01 |
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 |
8 |
Number Of Medical Services |
780 |
Number Of Medicare Beneficiaries With Medical Services |
453 |
Total Medical Submitted Charge Amount |
210210 |
Total Medical Medicare Allowed Amount |
131252.39 |
Total Medical Medicare Payment Amount |
102547.72 |
Total Medical Medicare Standardized Payment Amount |
101061.01 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
109 |
Number Of Beneficiaries Age 65 to 74 |
152 |
Number Of Beneficiaries Age 75 to 84 |
143 |
Number Of Beneficiaries Age Greater 84 |
49 |
Number Of Female Beneficiaries |
230 |
Number Of Male Beneficiaries |
223 |
Number Of Non Hispanic White Beneficiaries |
415 |
Number Of Black or African American Beneficiaries |
11 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
13 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
251 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
202 |
Percent Of With Atrial Fibrillation |
32 |
Percent Of With Alzheimers Disease or Dementia |
25 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
55 |
Percent Of With Chronic Kidney Disease |
60 |
Percent Of With Chronic Obstructive Pulmonary Disease |
41 |
Percent Of With Depression |
43 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
58 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
3.0293 |