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Data Sources: Centers for Medicare & Medicaid Services (CMS), Medicare Provider Utilization and Payment Data
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Methodology•Download Data
  1. Home
  2. Providers
  3. Randy Bergen
👶
MDIndividual

Randy Bergen, MD

NPI: 1316025497
Walnut Creek, CA
7 years of data
Pediatric Medicine
$19.7M
Total Payments
624.1K
Beneficiaries
624.5K
Services
1.32x
Markup Ratio

Peer Comparison

99th
percentile in specialty
This provider$19.7M
Specialty median$33.6K

📋 Key Findings

1Billed $19.7M over 7 years
299th percentile in Pediatric Medicine by payments
3357 services/day — physically implausible
4Payments surged 9080% in 2021
51 procedure with >3x markup

⚠️ This provider averages 357 services per working day — physically unusual for an individual practitioner

Based on 624.5K total services over 7 years (250 working days/year). Learn about impossible service volumes →

🔎 Data Analysis

This provider's $19.7M in total Medicare payments ranks in the 99th percentile of Pediatric Medicine providers nationally.

Averaging 357 services per working day raises questions about billing patterns.

Medicare payments to this provider grew 48538% from 2015 to 2021.

AI-generated analysis based on Medicare payment data.

Annual Medicare Payments

Annual Services Provided

Avg Payment per Service

Markup Ratio Over Time

📈

Notable: Payments increased 9080% in 2021

Year-over-year payment surges can indicate changes in practice volume, new services, or billing pattern shifts.

Submitted Charges vs. Medicare Payments

Average per-service amounts submitted by the provider compared to what Medicare actually paid — the gap represents the markup.

YearAvg SubmittedAvg PaidMarkup RatioGap per ServiceTotal PaymentsServicesBeneficiaries
2015$30.28$15.231.99x$15.05$38.9K2.1K2.1K
2016$24.43$15.551.57x$8.88$81.9K3.9K3.8K
2017$32.92$21.581.53x$11.34$134.0K5.4K5.4K
2018$50.22$26.641.89x$23.58$167.7K5.9K5.8K
2019$58.20$26.482.20x$31.72$215.2K8.4K8.4K
2020$57.50$29.611.94x$27.89$205.9K7.0K6.9K
2021$44.16$34.081.30x$10.08$18.9M591.8K591.6K

Top Procedures (19)

0002AAdm sarscov2 30mcg/0.3ml 2nd
$6.7M
166.0K services$40.61/svc1.28x markup
0012AAdm sarscov2 100mcg/0.5ml2nd
$5.1M
127.3K services$39.71/svc1.31x markup
0001AAdm sarscov2 30mcg/0.3ml 1st
$3.9M
164.7K services$23.69/svc1.25x markup
0011AAdm sarscov2 100mcg/0.5ml1st
$2.9M
127.1K services$22.90/svc1.27x markup
G0008Administration of influenza virus vaccine
$359.0K
15.3K services$23.44/svc2.60x markup
0031AAdm sarscov2 vac ad26 .5ml
$293.3K
6.7K services$43.50/svc1.34x markup
90662Vaccine for influenza for injection into muscle
$250.3K
6.1K services$41.04/svc1.61x markup
90686Vaccine for influenza for administration into muscle, 0.5 ml dosage
$77.7K
4.1K services$18.88/svc2.14x markup
90682Vaccine for influenza for injection into muscle
$47.1K
1.2K services$38.63/svc1.34x markup
90653Vaccine for influenza for injection into muscle
$27.5K
927 services$29.70/svc1.03x markup
Q2037Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluvirin)
$21.0K
1.3K services$16.35/svc1.30x markup
90656Vaccine for influenza for injection into muscle, patient 3 years and older
$18.4K
1.1K services$16.61/svc2.04x markup
90674Vaccine for influenza for administration into muscle, 0.5 ml dosage
$16.6K
578 services$28.68/svc1.68x markup
90471Administration of 1 vaccine⚠ 5.8x markup
$15.0K
1.3K services$11.39/svc5.77x markup
Q2035Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (afluria)
$5.6K
362 services$15.47/svc1.15x markup
90661Vaccine for influenza for injection into muscle
$2.2K
222 services$9.80/svc1.02x markup
Q2038Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluzone)
$920.40
78 services$11.80/svc1.69x markup
Q2039Influenza virus vaccine, not otherwise specified
$558.25
25 services$22.33/svc1.03x markup
G0009Administration of pneumococcal vaccine
$329.66
11 services$29.97/svc2.14x markup
Show detailed table ▾
CodeDescriptionServicesPaymentsAvg/ServiceMarkup
0002AAdm sarscov2 30mcg/0.3ml 2nd166.0K$6.7M$40.611.28x
0012AAdm sarscov2 100mcg/0.5ml2nd127.3K$5.1M$39.711.31x
0001AAdm sarscov2 30mcg/0.3ml 1st164.7K$3.9M$23.691.25x
0011AAdm sarscov2 100mcg/0.5ml1st127.1K$2.9M$22.901.27x
G0008Administration of influenza virus vaccine15.3K$359.0K$23.442.60x
0031AAdm sarscov2 vac ad26 .5ml6.7K$293.3K$43.501.34x
90662Vaccine for influenza for injection into muscle6.1K$250.3K$41.041.61x
90686Vaccine for influenza for administration into muscle, 0.5 ml dosage4.1K$77.7K$18.882.14x
90682Vaccine for influenza for injection into muscle1.2K$47.1K$38.631.34x
90653Vaccine for influenza for injection into muscle927$27.5K$29.701.03x
Q2037Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluvirin)1.3K$21.0K$16.351.30x
90656Vaccine for influenza for injection into muscle, patient 3 years and older1.1K$18.4K$16.612.04x
90674Vaccine for influenza for administration into muscle, 0.5 ml dosage578$16.6K$28.681.68x
90471Administration of 1 vaccine1.3K$15.0K$11.395.77x
Q2035Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (afluria)362$5.6K$15.471.15x
90661Vaccine for influenza for injection into muscle222$2.2K$9.801.02x
Q2038Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluzone)78$920.40$11.801.69x
Q2039Influenza virus vaccine, not otherwise specified25$558.25$22.331.03x
G0009Administration of pneumococcal vaccine11$329.66$29.972.14x

Markup Analysis

Charge-to-Payment Ratio

1.32x

This provider submits charges 1.32 times higher than what Medicare actually pays.

What This Means

A markup ratio of 1.32x means for every $100 Medicare pays, this provider initially charges $132. This is lower than the national average.

Location

Walnut Creek, CA

Provider Verification

Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.

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Data Sources

  • • Centers for Medicare & Medicaid Services (CMS)
  • • Medicare Provider Utilization and Payment Data (2014-2023)
  • • National Plan and Provider Enumeration System (NPPES)

Last Updated: February 2026 (data through 2023, the latest CMS release)

Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.

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