National Provider Identifier [NPI]: |
1073653655 |
Last Name Of The Provider |
KIM |
First Name Of The Provider |
BURTON |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
677 CHURCH ST NE |
Street Address 2 Of The Provider |
|
City Of The Provider |
MARIETTA |
Zip Code Of The Provider |
300601101 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pathology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
28 |
Number Of Services |
1921 |
Number Of Medicare Beneficiaries |
892 |
Total Submitted Charge Amount |
259241 |
Total Medicare Allowed Amount |
74578.01 |
Total Medicare Payment Amount |
57758.83 |
Total Medicare Standardized Payment Amount |
47406.62 |
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 |
28 |
Number Of Medical Services |
1921 |
Number Of Medicare Beneficiaries With Medical Services |
892 |
Total Medical Submitted Charge Amount |
259241 |
Total Medical Medicare Allowed Amount |
74578.01 |
Total Medical Medicare Payment Amount |
57758.83 |
Total Medical Medicare Standardized Payment Amount |
47406.62 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
175 |
Number Of Beneficiaries Age 65 to 74 |
394 |
Number Of Beneficiaries Age 75 to 84 |
255 |
Number Of Beneficiaries Age Greater 84 |
68 |
Number Of Female Beneficiaries |
523 |
Number Of Male Beneficiaries |
369 |
Number Of Non Hispanic White Beneficiaries |
648 |
Number Of Black or African American Beneficiaries |
191 |
Number Of AsianPacific Islander Beneficiaries |
17 |
Number Of Hispanic Beneficiaries |
22 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
688 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
204 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
23 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
52 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.0479 |