National Provider Identifier [NPI]: |
1508872938 |
Last Name Of The Provider |
BERGFELDER |
First Name Of The Provider |
PAUL |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1915 CHESTER BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
RICHMOND |
Zip Code Of The Provider |
473741212 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
2759 |
Number Of Medicare Beneficiaries |
684 |
Total Submitted Charge Amount |
275904 |
Total Medicare Allowed Amount |
185385.57 |
Total Medicare Payment Amount |
127187.1 |
Total Medicare Standardized Payment Amount |
139526.86 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
213 |
Number Of Medicare Beneficiaries With Drug Services |
208 |
Total Drug Submitted ChargeAmount |
7540 |
Total Drug Medicare AllowedAmount |
2082.27 |
Total Drug Medicare PaymentAmount |
1992.9 |
Total Drug Medicare Standardized Payment Amount |
1992.9 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
15 |
Number Of Medical Services |
2546 |
Number Of Medicare Beneficiaries With Medical Services |
684 |
Total Medical Submitted Charge Amount |
268364 |
Total Medical Medicare Allowed Amount |
183303.3 |
Total Medical Medicare Payment Amount |
125194.2 |
Total Medical Medicare Standardized Payment Amount |
137533.96 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
56 |
Number Of Beneficiaries Age 65 to 74 |
288 |
Number Of Beneficiaries Age 75 to 84 |
234 |
Number Of Beneficiaries Age Greater 84 |
106 |
Number Of Female Beneficiaries |
391 |
Number Of Male Beneficiaries |
293 |
Number Of Non Hispanic White Beneficiaries |
673 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
620 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
64 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
3 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
30 |
Percent Of With Hypertension |
45 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
0.9958 |