| National Provider Identifier [NPI]: | 1205097227 |
| Last Name Of The Provider | BURKALL-LEWIS |
| First Name Of The Provider | RAIGAN |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 80 68TH ST SE |
| Street Address 2 Of The Provider | |
| City Of The Provider | GRAND RAPIDS |
| Zip Code Of The Provider | 495486980 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 91 |
| Number Of Services | 1258.5 |
| Number Of Medicare Beneficiaries | 353 |
| Total Submitted Charge Amount | 89805.5 |
| Total Medicare Allowed Amount | 46786.04 |
| Total Medicare Payment Amount | 28805.4 |
| Total Medicare Standardized Payment Amount | 30803.68 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 17 |
| Number Of Drug Services | 591.5 |
| Number Of Medicare Beneficiaries With Drug Services | 55 |
| Total Drug Submitted ChargeAmount | 2864.5 |
| Total Drug Medicare AllowedAmount | 1013.38 |
| Total Drug Medicare PaymentAmount | 952.82 |
| Total Drug Medicare Standardized Payment Amount | 952.82 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 74 |
| Number Of Medical Services | 667 |
| Number Of Medicare Beneficiaries With Medical Services | 350 |
| Total Medical Submitted Charge Amount | 86941 |
| Total Medical Medicare Allowed Amount | 45772.66 |
| Total Medical Medicare Payment Amount | 27852.58 |
| Total Medical Medicare Standardized Payment Amount | 29850.86 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 104 |
| Number Of Beneficiaries Age 65 to 74 | 103 |
| Number Of Beneficiaries Age 75 to 84 | 88 |
| Number Of Beneficiaries Age Greater 84 | 58 |
| Number Of Female Beneficiaries | 248 |
| Number Of Male Beneficiaries | 105 |
| Number Of Non Hispanic White Beneficiaries | 298 |
| Number Of Black or African American Beneficiaries | 29 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 14 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 251 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 102 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0871 |