| National Provider Identifier [NPI]: | 1265493845 |
| Last Name Of The Provider | BURKERT |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 205 S MAIN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | POLAND |
| Zip Code Of The Provider | 445142026 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 38 |
| Number Of Services | 2812 |
| Number Of Medicare Beneficiaries | 488 |
| Total Submitted Charge Amount | 196042 |
| Total Medicare Allowed Amount | 182046.33 |
| Total Medicare Payment Amount | 136290.89 |
| Total Medicare Standardized Payment Amount | 141746.01 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 428 |
| Number Of Medicare Beneficiaries With Drug Services | 301 |
| Total Drug Submitted ChargeAmount | 10350 |
| Total Drug Medicare AllowedAmount | 8558.83 |
| Total Drug Medicare PaymentAmount | 8301.84 |
| Total Drug Medicare Standardized Payment Amount | 8301.84 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 34 |
| Number Of Medical Services | 2384 |
| Number Of Medicare Beneficiaries With Medical Services | 488 |
| Total Medical Submitted Charge Amount | 185692 |
| Total Medical Medicare Allowed Amount | 173487.5 |
| Total Medical Medicare Payment Amount | 127989.05 |
| Total Medical Medicare Standardized Payment Amount | 133444.17 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 24 |
| Number Of Beneficiaries Age 65 to 74 | 170 |
| Number Of Beneficiaries Age 75 to 84 | 170 |
| Number Of Beneficiaries Age Greater 84 | 124 |
| Number Of Female Beneficiaries | 267 |
| Number Of Male Beneficiaries | 221 |
| Number Of Non Hispanic White Beneficiaries | 467 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 461 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 27 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1528 |