National Provider Identifier [NPI]: |
1154399459 |
Last Name Of The Provider |
BURKE |
First Name Of The Provider |
J |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5169 COTTONWOOD ST |
Street Address 2 Of The Provider |
BLDG. B, SUITE 520 |
City Of The Provider |
MURRAY |
Zip Code Of The Provider |
841076767 |
State Code Of The Provider |
UT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
74 |
Number Of Services |
1948 |
Number Of Medicare Beneficiaries |
1143 |
Total Submitted Charge Amount |
417896 |
Total Medicare Allowed Amount |
145838.62 |
Total Medicare Payment Amount |
105850.85 |
Total Medicare Standardized Payment Amount |
109001.4 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
74 |
Number Of Medical Services |
1948 |
Number Of Medicare Beneficiaries With Medical Services |
1143 |
Total Medical Submitted Charge Amount |
417896 |
Total Medical Medicare Allowed Amount |
145838.62 |
Total Medical Medicare Payment Amount |
105850.85 |
Total Medical Medicare Standardized Payment Amount |
109001.4 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
126 |
Number Of Beneficiaries Age 65 to 74 |
436 |
Number Of Beneficiaries Age 75 to 84 |
388 |
Number Of Beneficiaries Age Greater 84 |
193 |
Number Of Female Beneficiaries |
528 |
Number Of Male Beneficiaries |
615 |
Number Of Non Hispanic White Beneficiaries |
1041 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
22 |
Number Of Hispanic Beneficiaries |
50 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
13 |
Number Of Beneficiaries With Medicare Only Entitlement |
1010 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
133 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
38 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
63 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.591 |