National Provider Identifier [NPI]: |
1669530879 |
Last Name Of The Provider |
BURDETTE |
First Name Of The Provider |
JENNIFER |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7700 HIGHWAY 69 S |
Street Address 2 Of The Provider |
SUITE C |
City Of The Provider |
TUSCALOOSA |
Zip Code Of The Provider |
354058783 |
State Code Of The Provider |
AL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
83 |
Number Of Services |
4828 |
Number Of Medicare Beneficiaries |
675 |
Total Submitted Charge Amount |
251086.12 |
Total Medicare Allowed Amount |
191583.44 |
Total Medicare Payment Amount |
136126.28 |
Total Medicare Standardized Payment Amount |
147745.74 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
11 |
Number Of Drug Services |
957 |
Number Of Medicare Beneficiaries With Drug Services |
190 |
Total Drug Submitted ChargeAmount |
13939.12 |
Total Drug Medicare AllowedAmount |
3458.05 |
Total Drug Medicare PaymentAmount |
2809.25 |
Total Drug Medicare Standardized Payment Amount |
2809.25 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
72 |
Number Of Medical Services |
3871 |
Number Of Medicare Beneficiaries With Medical Services |
675 |
Total Medical Submitted Charge Amount |
237147 |
Total Medical Medicare Allowed Amount |
188125.39 |
Total Medical Medicare Payment Amount |
133317.03 |
Total Medical Medicare Standardized Payment Amount |
144936.49 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
204 |
Number Of Beneficiaries Age 65 to 74 |
235 |
Number Of Beneficiaries Age 75 to 84 |
166 |
Number Of Beneficiaries Age Greater 84 |
70 |
Number Of Female Beneficiaries |
439 |
Number Of Male Beneficiaries |
236 |
Number Of Non Hispanic White Beneficiaries |
487 |
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 |
481 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
194 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
31 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
62 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.5997 |