| National Provider Identifier [NPI]: | 1669552683 |
| Last Name Of The Provider | BERGMAN |
| First Name Of The Provider | SUSAN |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 600 WORCESTER RD |
| Street Address 2 Of The Provider | SUITE LL3 |
| City Of The Provider | FRAMINGHAM |
| Zip Code Of The Provider | 017025356 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physical Medicine and Rehabilitation |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 18 |
| Number Of Services | 2298 |
| Number Of Medicare Beneficiaries | 67 |
| Total Submitted Charge Amount | 49632.5 |
| Total Medicare Allowed Amount | 40737.86 |
| Total Medicare Payment Amount | 31187.06 |
| Total Medicare Standardized Payment Amount | 29836.66 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 2088 |
| Number Of Medicare Beneficiaries With Drug Services | 20 |
| Total Drug Submitted ChargeAmount | 15162.5 |
| Total Drug Medicare AllowedAmount | 12726.89 |
| Total Drug Medicare PaymentAmount | 9977.88 |
| Total Drug Medicare Standardized Payment Amount | 9977.88 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 15 |
| Number Of Medical Services | 210 |
| Number Of Medicare Beneficiaries With Medical Services | 67 |
| Total Medical Submitted Charge Amount | 34470 |
| Total Medical Medicare Allowed Amount | 28010.97 |
| Total Medical Medicare Payment Amount | 21209.18 |
| Total Medical Medicare Standardized Payment Amount | 19858.78 |
| Average Age Of Beneficiaries | 60 |
| Number Of Beneficiaries Age Less65 | 40 |
| Number Of Beneficiaries Age 65 to 74 | 16 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 33 |
| Number Of Male Beneficiaries | 34 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 32 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 35 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 43 |
| Percent Of With Diabetes | |
| Percent Of With Hyperlipidemia | 34 |
| Percent Of With Hypertension | 40 |
| Percent Of With Ischemic Heart Disease | 21 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 58 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 2.0498 |