National Provider Identifier [NPI]: |
1417055765 |
Last Name Of The Provider |
BURRELL |
First Name Of The Provider |
BARBARA |
Middle Initial Of The Provider |
F |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1465 COMMERCE DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
ALGONQUIN |
Zip Code Of The Provider |
601025916 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
50 |
Number Of Services |
2135 |
Number Of Medicare Beneficiaries |
403 |
Total Submitted Charge Amount |
241809.2 |
Total Medicare Allowed Amount |
118221.03 |
Total Medicare Payment Amount |
88374.71 |
Total Medicare Standardized Payment Amount |
92218.2 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
116 |
Number Of Medicare Beneficiaries With Drug Services |
52 |
Total Drug Submitted ChargeAmount |
3609.2 |
Total Drug Medicare AllowedAmount |
2688.51 |
Total Drug Medicare PaymentAmount |
2458.11 |
Total Drug Medicare Standardized Payment Amount |
2458.11 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
40 |
Number Of Medical Services |
2019 |
Number Of Medicare Beneficiaries With Medical Services |
403 |
Total Medical Submitted Charge Amount |
238200 |
Total Medical Medicare Allowed Amount |
115532.52 |
Total Medical Medicare Payment Amount |
85916.6 |
Total Medical Medicare Standardized Payment Amount |
89760.09 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
34 |
Number Of Beneficiaries Age 65 to 74 |
212 |
Number Of Beneficiaries Age 75 to 84 |
119 |
Number Of Beneficiaries Age Greater 84 |
38 |
Number Of Female Beneficiaries |
316 |
Number Of Male Beneficiaries |
87 |
Number Of Non Hispanic White Beneficiaries |
388 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
381 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
22 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
22 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
52 |
Percent Of With Ischemic Heart Disease |
24 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
0.8258 |