| National Provider Identifier [NPI]: | 1033183769 |
| Last Name Of The Provider | BERGGREEN |
| First Name Of The Provider | CHARLES |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9103 JEFFERSON HWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | BATON ROUGE |
| Zip Code Of The Provider | 708092440 |
| State Code Of The Provider | LA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Gastroenterology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 58 |
| Number Of Services | 4713 |
| Number Of Medicare Beneficiaries | 550 |
| Total Submitted Charge Amount | 540517.2 |
| Total Medicare Allowed Amount | 172063.76 |
| Total Medicare Payment Amount | 129550.5 |
| Total Medicare Standardized Payment Amount | 131923.47 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 2762 |
| Number Of Medicare Beneficiaries With Drug Services | 28 |
| Total Drug Submitted ChargeAmount | 3851.2 |
| Total Drug Medicare AllowedAmount | 630.88 |
| Total Drug Medicare PaymentAmount | 504.72 |
| Total Drug Medicare Standardized Payment Amount | 504.72 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 56 |
| Number Of Medical Services | 1951 |
| Number Of Medicare Beneficiaries With Medical Services | 550 |
| Total Medical Submitted Charge Amount | 536666 |
| Total Medical Medicare Allowed Amount | 171432.88 |
| Total Medical Medicare Payment Amount | 129045.78 |
| Total Medical Medicare Standardized Payment Amount | 131418.75 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 66 |
| Number Of Beneficiaries Age 65 to 74 | 279 |
| Number Of Beneficiaries Age 75 to 84 | 157 |
| Number Of Beneficiaries Age Greater 84 | 48 |
| Number Of Female Beneficiaries | 314 |
| Number Of Male Beneficiaries | 236 |
| Number Of Non Hispanic White Beneficiaries | 425 |
| Number Of Black or African American Beneficiaries | 105 |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 463 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 87 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.3172 |