| National Provider Identifier [NPI]: | 1639152630 |
| Last Name Of The Provider | BERSOUX |
| First Name Of The Provider | SOPHIE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 13400 E SHEA BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | SCOTTSDALE |
| Zip Code Of The Provider | 852595404 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 22 |
| Number Of Services | 1442 |
| Number Of Medicare Beneficiaries | 760 |
| Total Submitted Charge Amount | 101152.63 |
| Total Medicare Allowed Amount | 81534.27 |
| Total Medicare Payment Amount | 55024.59 |
| Total Medicare Standardized Payment Amount | 59870.28 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 93 |
| Number Of Medicare Beneficiaries With Drug Services | 54 |
| Total Drug Submitted ChargeAmount | 10089.65 |
| Total Drug Medicare AllowedAmount | 4988.57 |
| Total Drug Medicare PaymentAmount | 4845.85 |
| Total Drug Medicare Standardized Payment Amount | 4845.85 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 15 |
| Number Of Medical Services | 1349 |
| Number Of Medicare Beneficiaries With Medical Services | 760 |
| Total Medical Submitted Charge Amount | 91062.98 |
| Total Medical Medicare Allowed Amount | 76545.7 |
| Total Medical Medicare Payment Amount | 50178.74 |
| Total Medical Medicare Standardized Payment Amount | 55024.43 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 17 |
| Number Of Beneficiaries Age 65 to 74 | 249 |
| Number Of Beneficiaries Age 75 to 84 | 304 |
| Number Of Beneficiaries Age Greater 84 | 190 |
| Number Of Female Beneficiaries | 417 |
| Number Of Male Beneficiaries | 343 |
| Number Of Non Hispanic White Beneficiaries | 711 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 16 |
| Number Of Hispanic Beneficiaries | 15 |
| 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 | 33 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 59 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.2727 |