| National Provider Identifier [NPI]: | 1679508071 |
| Last Name Of The Provider | BURCH |
| First Name Of The Provider | PATRICE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2301 E 93RD ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | CHICAGO |
| Zip Code Of The Provider | 606173913 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 72 |
| Number Of Services | 1996 |
| Number Of Medicare Beneficiaries | 289 |
| Total Submitted Charge Amount | 81645.86 |
| Total Medicare Allowed Amount | 42526.11 |
| Total Medicare Payment Amount | 28720.65 |
| Total Medicare Standardized Payment Amount | 27088.22 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 17 |
| Number Of Drug Services | 1389 |
| Number Of Medicare Beneficiaries With Drug Services | 97 |
| Total Drug Submitted ChargeAmount | 8428.36 |
| Total Drug Medicare AllowedAmount | 1773.68 |
| Total Drug Medicare PaymentAmount | 1376.16 |
| Total Drug Medicare Standardized Payment Amount | 1376.16 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 55 |
| Number Of Medical Services | 607 |
| Number Of Medicare Beneficiaries With Medical Services | 289 |
| Total Medical Submitted Charge Amount | 73217.5 |
| Total Medical Medicare Allowed Amount | 40752.43 |
| Total Medical Medicare Payment Amount | 27344.49 |
| Total Medical Medicare Standardized Payment Amount | 25712.06 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 55 |
| Number Of Beneficiaries Age 65 to 74 | 147 |
| Number Of Beneficiaries Age 75 to 84 | 69 |
| Number Of Beneficiaries Age Greater 84 | 18 |
| Number Of Female Beneficiaries | 205 |
| Number Of Male Beneficiaries | 84 |
| Number Of Non Hispanic White Beneficiaries | 27 |
| Number Of Black or African American Beneficiaries | 249 |
| 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 | 232 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 57 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1122 |