| National Provider Identifier [NPI]: | 1962707349 |
| Last Name Of The Provider | BURKE |
| First Name Of The Provider | PHIL |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 535 NW 9TH ST |
| Street Address 2 Of The Provider | SUITE 205 |
| City Of The Provider | OKLAHOMA CITY |
| Zip Code Of The Provider | 731021070 |
| State Code Of The Provider | OK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 8 |
| Number Of Services | 125 |
| Number Of Medicare Beneficiaries | 55 |
| Total Submitted Charge Amount | 21575 |
| Total Medicare Allowed Amount | 9058.95 |
| Total Medicare Payment Amount | 5002.6 |
| Total Medicare Standardized Payment Amount | 6791.14 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 16 |
| Number Of Medicare Beneficiaries With Drug Services | 16 |
| Total Drug Submitted ChargeAmount | 1677 |
| Total Drug Medicare AllowedAmount | 909.15 |
| Total Drug Medicare PaymentAmount | 890.93 |
| Total Drug Medicare Standardized Payment Amount | 890.93 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 6 |
| Number Of Medical Services | 109 |
| Number Of Medicare Beneficiaries With Medical Services | 55 |
| Total Medical Submitted Charge Amount | 19898 |
| Total Medical Medicare Allowed Amount | 8149.8 |
| Total Medical Medicare Payment Amount | 4111.67 |
| Total Medical Medicare Standardized Payment Amount | 5900.21 |
| Average Age Of Beneficiaries | 52 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | |
| Number Of Male Beneficiaries | |
| Number Of Non Hispanic White Beneficiaries | 36 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 0 |
| Number Of Beneficiaries With Medicare Only Entitlement | 19 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 36 |
| Percent Of With Atrial Fibrillation | 0 |
| Percent Of With Alzheimers Disease or Dementia | 0 |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | |
| Percent Of With Hyperlipidemia | 33 |
| Percent Of With Hypertension | 29 |
| Percent Of With Ischemic Heart Disease | |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.3576 |