| National Provider Identifier [NPI]: | 1598810574 |
| Last Name Of The Provider | BERGERON |
| First Name Of The Provider | NICOLE |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 122 SHERWOOD FOREST DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | NEW ORLEANS |
| Zip Code Of The Provider | 701193717 |
| State Code Of The Provider | LA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 101 |
| Number Of Services | 2267 |
| Number Of Medicare Beneficiaries | 728 |
| Total Submitted Charge Amount | 336418 |
| Total Medicare Allowed Amount | 109510.59 |
| Total Medicare Payment Amount | 76652.66 |
| Total Medicare Standardized Payment Amount | 85491.98 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 23 |
| Number Of Drug Services | 720 |
| Number Of Medicare Beneficiaries With Drug Services | 246 |
| Total Drug Submitted ChargeAmount | 6577 |
| Total Drug Medicare AllowedAmount | 1390.99 |
| Total Drug Medicare PaymentAmount | 1047.65 |
| Total Drug Medicare Standardized Payment Amount | 1047.65 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 78 |
| Number Of Medical Services | 1547 |
| Number Of Medicare Beneficiaries With Medical Services | 728 |
| Total Medical Submitted Charge Amount | 329841 |
| Total Medical Medicare Allowed Amount | 108119.6 |
| Total Medical Medicare Payment Amount | 75605.01 |
| Total Medical Medicare Standardized Payment Amount | 84444.33 |
| Average Age Of Beneficiaries | 63 |
| Number Of Beneficiaries Age Less65 | 302 |
| Number Of Beneficiaries Age 65 to 74 | 248 |
| Number Of Beneficiaries Age 75 to 84 | 138 |
| Number Of Beneficiaries Age Greater 84 | 40 |
| Number Of Female Beneficiaries | 412 |
| Number Of Male Beneficiaries | 316 |
| Number Of Non Hispanic White Beneficiaries | 469 |
| Number Of Black or African American Beneficiaries | 230 |
| 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 | 12 |
| Number Of Beneficiaries With Medicare Only Entitlement | 434 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 294 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0509 |