National Provider Identifier [NPI]: |
1487687331 |
Last Name Of The Provider |
BURTON |
First Name Of The Provider |
KELVIN |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2022 FAIRBURN RD |
Street Address 2 Of The Provider |
SUITE D |
City Of The Provider |
DOUGLASVILLE |
Zip Code Of The Provider |
301351062 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
90 |
Number Of Services |
5746 |
Number Of Medicare Beneficiaries |
337 |
Total Submitted Charge Amount |
458428.13 |
Total Medicare Allowed Amount |
257155.69 |
Total Medicare Payment Amount |
191513.76 |
Total Medicare Standardized Payment Amount |
191313.42 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
20 |
Number Of Drug Services |
661 |
Number Of Medicare Beneficiaries With Drug Services |
133 |
Total Drug Submitted ChargeAmount |
28122.2 |
Total Drug Medicare AllowedAmount |
5184.39 |
Total Drug Medicare PaymentAmount |
4628.91 |
Total Drug Medicare Standardized Payment Amount |
4628.91 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
70 |
Number Of Medical Services |
5085 |
Number Of Medicare Beneficiaries With Medical Services |
337 |
Total Medical Submitted Charge Amount |
430305.93 |
Total Medical Medicare Allowed Amount |
251971.3 |
Total Medical Medicare Payment Amount |
186884.85 |
Total Medical Medicare Standardized Payment Amount |
186684.51 |
Average Age Of Beneficiaries |
62 |
Number Of Beneficiaries Age Less65 |
166 |
Number Of Beneficiaries Age 65 to 74 |
108 |
Number Of Beneficiaries Age 75 to 84 |
51 |
Number Of Beneficiaries Age Greater 84 |
12 |
Number Of Female Beneficiaries |
208 |
Number Of Male Beneficiaries |
129 |
Number Of Non Hispanic White Beneficiaries |
190 |
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 |
212 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
125 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
21 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1749 |