National Provider Identifier [NPI]: |
1033129390 |
Last Name Of The Provider |
BURAN |
First Name Of The Provider |
KENNETH |
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 |
107 W MAIN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
MARQUETTE |
Zip Code Of The Provider |
498554651 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Gastroenterology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
69 |
Number Of Services |
1138 |
Number Of Medicare Beneficiaries |
559 |
Total Submitted Charge Amount |
666418 |
Total Medicare Allowed Amount |
161574.4 |
Total Medicare Payment Amount |
123938.14 |
Total Medicare Standardized Payment Amount |
130667.71 |
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 |
69 |
Number Of Medical Services |
1138 |
Number Of Medicare Beneficiaries With Medical Services |
559 |
Total Medical Submitted Charge Amount |
666418 |
Total Medical Medicare Allowed Amount |
161574.4 |
Total Medical Medicare Payment Amount |
123938.14 |
Total Medical Medicare Standardized Payment Amount |
130667.71 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
135 |
Number Of Beneficiaries Age 65 to 74 |
230 |
Number Of Beneficiaries Age 75 to 84 |
147 |
Number Of Beneficiaries Age Greater 84 |
47 |
Number Of Female Beneficiaries |
317 |
Number Of Male Beneficiaries |
242 |
Number Of Non Hispanic White Beneficiaries |
537 |
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 |
426 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
133 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.3064 |