| National Provider Identifier [NPI]: | 1346273596 |
| Last Name Of The Provider | BERGSTROM |
| First Name Of The Provider | CHRIS |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1365 CLIFTON RD NE # B |
| Street Address 2 Of The Provider | |
| City Of The Provider | ATLANTA |
| Zip Code Of The Provider | 303221013 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 67 |
| Number Of Services | 9180 |
| Number Of Medicare Beneficiaries | 1178 |
| Total Submitted Charge Amount | 4534362 |
| Total Medicare Allowed Amount | 1598462.9 |
| Total Medicare Payment Amount | 1226115.01 |
| Total Medicare Standardized Payment Amount | 1232614.77 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 4385 |
| Number Of Medicare Beneficiaries With Drug Services | 276 |
| Total Drug Submitted ChargeAmount | 2666481 |
| Total Drug Medicare AllowedAmount | 1017577.88 |
| Total Drug Medicare PaymentAmount | 796005.56 |
| Total Drug Medicare Standardized Payment Amount | 796005.56 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 59 |
| Number Of Medical Services | 4795 |
| Number Of Medicare Beneficiaries With Medical Services | 1175 |
| Total Medical Submitted Charge Amount | 1867881 |
| Total Medical Medicare Allowed Amount | 580885.02 |
| Total Medical Medicare Payment Amount | 430109.45 |
| Total Medical Medicare Standardized Payment Amount | 436609.21 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 107 |
| Number Of Beneficiaries Age 65 to 74 | 457 |
| Number Of Beneficiaries Age 75 to 84 | 381 |
| Number Of Beneficiaries Age Greater 84 | 233 |
| Number Of Female Beneficiaries | 687 |
| Number Of Male Beneficiaries | 491 |
| Number Of Non Hispanic White Beneficiaries | 991 |
| Number Of Black or African American Beneficiaries | 129 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 24 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 20 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1017 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 161 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.4739 |