| National Provider Identifier [NPI]: | 1033126578 |
| Last Name Of The Provider | SERGILE |
| First Name Of The Provider | ELIZABETH |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 960 JOHNSON FERRY RD NE |
| Street Address 2 Of The Provider | SUITE 300 |
| City Of The Provider | ATLANTA |
| Zip Code Of The Provider | 303421631 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 48 |
| Number Of Services | 686 |
| Number Of Medicare Beneficiaries | 125 |
| Total Submitted Charge Amount | 61917.48 |
| Total Medicare Allowed Amount | 29549.5 |
| Total Medicare Payment Amount | 22161.34 |
| Total Medicare Standardized Payment Amount | 22217.35 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 44 |
| Number Of Medicare Beneficiaries With Drug Services | 35 |
| Total Drug Submitted ChargeAmount | 2543.85 |
| Total Drug Medicare AllowedAmount | 1510.35 |
| Total Drug Medicare PaymentAmount | 1480.06 |
| Total Drug Medicare Standardized Payment Amount | 1480.06 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 43 |
| Number Of Medical Services | 642 |
| Number Of Medicare Beneficiaries With Medical Services | 125 |
| Total Medical Submitted Charge Amount | 59373.63 |
| Total Medical Medicare Allowed Amount | 28039.15 |
| Total Medical Medicare Payment Amount | 20681.28 |
| Total Medical Medicare Standardized Payment Amount | 20737.29 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 87 |
| Number Of Beneficiaries Age 75 to 84 | 18 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 84 |
| Number Of Male Beneficiaries | 41 |
| Number Of Non Hispanic White Beneficiaries | 103 |
| Number Of Black or African American Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 10 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 18 |
| Percent Of With Hyperlipidemia | 38 |
| Percent Of With Hypertension | 44 |
| Percent Of With Ischemic Heart Disease | 11 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 28 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7861 |