| National Provider Identifier [NPI]: | 1740217603 |
| Last Name Of The Provider | BURR |
| First Name Of The Provider | RANDALL |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1618 S. MILLENNIUM WAY |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | MERIDIAN |
| Zip Code Of The Provider | 836426457 |
| State Code Of The Provider | ID |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 100 |
| Number Of Services | 8116 |
| Number Of Medicare Beneficiaries | 1348 |
| Total Submitted Charge Amount | 964392 |
| Total Medicare Allowed Amount | 438577.63 |
| Total Medicare Payment Amount | 308013.15 |
| Total Medicare Standardized Payment Amount | 332129.73 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 206 |
| Number Of Medicare Beneficiaries With Drug Services | 52 |
| Total Drug Submitted ChargeAmount | 2878 |
| Total Drug Medicare AllowedAmount | 2456.25 |
| Total Drug Medicare PaymentAmount | 1890.53 |
| Total Drug Medicare Standardized Payment Amount | 1890.53 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 98 |
| Number Of Medical Services | 7910 |
| Number Of Medicare Beneficiaries With Medical Services | 1348 |
| Total Medical Submitted Charge Amount | 961514 |
| Total Medical Medicare Allowed Amount | 436121.38 |
| Total Medical Medicare Payment Amount | 306122.62 |
| Total Medical Medicare Standardized Payment Amount | 330239.2 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 43 |
| Number Of Beneficiaries Age 65 to 74 | 561 |
| Number Of Beneficiaries Age 75 to 84 | 557 |
| Number Of Beneficiaries Age Greater 84 | 187 |
| Number Of Female Beneficiaries | 637 |
| Number Of Male Beneficiaries | 711 |
| Number Of Non Hispanic White Beneficiaries | 1315 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 14 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1312 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 36 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 55 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 2 |
| Average HCC Risk Score Of Beneficiaries | 0.9105 |