| National Provider Identifier [NPI]: | 1285634105 |
| Last Name Of The Provider | SERGOTT |
| First Name Of The Provider | ROBERT |
| 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 | 840 WALNUT ST |
| Street Address 2 Of The Provider | SUITE 930 |
| City Of The Provider | PHILADELPHIA |
| Zip Code Of The Provider | 191075109 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 37 |
| Number Of Services | 5142 |
| Number Of Medicare Beneficiaries | 1534 |
| Total Submitted Charge Amount | 567259.3 |
| Total Medicare Allowed Amount | 235899.1 |
| Total Medicare Payment Amount | 172647.21 |
| Total Medicare Standardized Payment Amount | 164423.68 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 2422 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 15929 |
| Total Drug Medicare AllowedAmount | 12940.65 |
| Total Drug Medicare PaymentAmount | 10140.9 |
| Total Drug Medicare Standardized Payment Amount | 10140.9 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 35 |
| Number Of Medical Services | 2720 |
| Number Of Medicare Beneficiaries With Medical Services | 1534 |
| Total Medical Submitted Charge Amount | 551330.3 |
| Total Medical Medicare Allowed Amount | 222958.45 |
| Total Medical Medicare Payment Amount | 162506.31 |
| Total Medical Medicare Standardized Payment Amount | 154282.78 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 286 |
| Number Of Beneficiaries Age 65 to 74 | 614 |
| Number Of Beneficiaries Age 75 to 84 | 447 |
| Number Of Beneficiaries Age Greater 84 | 187 |
| Number Of Female Beneficiaries | 935 |
| Number Of Male Beneficiaries | 599 |
| Number Of Non Hispanic White Beneficiaries | 1125 |
| Number Of Black or African American Beneficiaries | 301 |
| Number Of AsianPacific Islander Beneficiaries | 41 |
| Number Of Hispanic Beneficiaries | 41 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1273 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 261 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.2885 |