| National Provider Identifier [NPI]: | 1396738407 |
| Last Name Of The Provider | BERGNER |
| First Name Of The Provider | DONALD |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1840 MEASE DRIVE |
| Street Address 2 Of The Provider | SUITE 300 |
| City Of The Provider | SAFETY HARBOR |
| Zip Code Of The Provider | 34695 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 86 |
| Number Of Services | 17677 |
| Number Of Medicare Beneficiaries | 698 |
| Total Submitted Charge Amount | 764185.8 |
| Total Medicare Allowed Amount | 414247.25 |
| Total Medicare Payment Amount | 313560.09 |
| Total Medicare Standardized Payment Amount | 315590.01 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 12263 |
| Number Of Medicare Beneficiaries With Drug Services | 49 |
| Total Drug Submitted ChargeAmount | 231580.8 |
| Total Drug Medicare AllowedAmount | 130528.92 |
| Total Drug Medicare PaymentAmount | 100696.49 |
| Total Drug Medicare Standardized Payment Amount | 100696.49 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 78 |
| Number Of Medical Services | 5414 |
| Number Of Medicare Beneficiaries With Medical Services | 698 |
| Total Medical Submitted Charge Amount | 532605 |
| Total Medical Medicare Allowed Amount | 283718.33 |
| Total Medical Medicare Payment Amount | 212863.6 |
| Total Medical Medicare Standardized Payment Amount | 214893.52 |
| Average Age Of Beneficiaries | 79 |
| Number Of Beneficiaries Age Less65 | 37 |
| Number Of Beneficiaries Age 65 to 74 | 190 |
| Number Of Beneficiaries Age 75 to 84 | 258 |
| Number Of Beneficiaries Age Greater 84 | 213 |
| Number Of Female Beneficiaries | 165 |
| Number Of Male Beneficiaries | 533 |
| Number Of Non Hispanic White Beneficiaries | 661 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 15 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 660 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 38 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 25 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.529 |