| National Provider Identifier [NPI]: | 1619978418 |
| Last Name Of The Provider | BURCHELL |
| First Name Of The Provider | DEL |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2900 CHANCELLOR DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | CRESTVIEW HILLS |
| Zip Code Of The Provider | 410175427 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 56 |
| Number Of Services | 6350 |
| Number Of Medicare Beneficiaries | 3080 |
| Total Submitted Charge Amount | 339327 |
| Total Medicare Allowed Amount | 199559.44 |
| Total Medicare Payment Amount | 147805.9 |
| Total Medicare Standardized Payment Amount | 157866.62 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 90 |
| Number Of Medicare Beneficiaries With Drug Services | 66 |
| Total Drug Submitted ChargeAmount | 5656 |
| Total Drug Medicare AllowedAmount | 4065.13 |
| Total Drug Medicare PaymentAmount | 3863.66 |
| Total Drug Medicare Standardized Payment Amount | 3863.66 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 47 |
| Number Of Medical Services | 6260 |
| Number Of Medicare Beneficiaries With Medical Services | 3080 |
| Total Medical Submitted Charge Amount | 333671 |
| Total Medical Medicare Allowed Amount | 195494.31 |
| Total Medical Medicare Payment Amount | 143942.24 |
| Total Medical Medicare Standardized Payment Amount | 154002.96 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 690 |
| Number Of Beneficiaries Age 65 to 74 | 940 |
| Number Of Beneficiaries Age 75 to 84 | 903 |
| Number Of Beneficiaries Age Greater 84 | 547 |
| Number Of Female Beneficiaries | 1756 |
| Number Of Male Beneficiaries | 1324 |
| Number Of Non Hispanic White Beneficiaries | 2939 |
| Number Of Black or African American Beneficiaries | 78 |
| Number Of AsianPacific Islander Beneficiaries | 19 |
| Number Of Hispanic Beneficiaries | 20 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 24 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2238 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 842 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 41 |
| Percent Of With Chronic Kidney Disease | 46 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 36 |
| Percent Of With Depression | 44 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 56 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 56 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.9438 |