National Provider Identifier [NPI]: |
1750375887 |
Last Name Of The Provider |
BURKET |
First Name Of The Provider |
MARK |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3000 ARLINGTON AVE |
Street Address 2 Of The Provider |
MEDICINE |
City Of The Provider |
TOLEDO |
Zip Code Of The Provider |
436142595 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
69 |
Number Of Services |
911 |
Number Of Medicare Beneficiaries |
505 |
Total Submitted Charge Amount |
287351.7 |
Total Medicare Allowed Amount |
104882.49 |
Total Medicare Payment Amount |
77443.5 |
Total Medicare Standardized Payment Amount |
80792 |
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 |
911 |
Number Of Medicare Beneficiaries With Medical Services |
505 |
Total Medical Submitted Charge Amount |
287351.7 |
Total Medical Medicare Allowed Amount |
104882.49 |
Total Medical Medicare Payment Amount |
77443.5 |
Total Medical Medicare Standardized Payment Amount |
80792 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
79 |
Number Of Beneficiaries Age 65 to 74 |
201 |
Number Of Beneficiaries Age 75 to 84 |
156 |
Number Of Beneficiaries Age Greater 84 |
69 |
Number Of Female Beneficiaries |
207 |
Number Of Male Beneficiaries |
298 |
Number Of Non Hispanic White Beneficiaries |
449 |
Number Of Black or African American Beneficiaries |
29 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
16 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
411 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
94 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
41 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.7483 |