| National Provider Identifier [NPI]: | 1932435328 |
| Last Name Of The Provider | BURT |
| First Name Of The Provider | JEREMY |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 600 N WOLFE ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | BALTIMORE |
| Zip Code Of The Provider | 212870801 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 120 |
| Number Of Services | 40154 |
| Number Of Medicare Beneficiaries | 3967 |
| Total Submitted Charge Amount | 1160590.65 |
| Total Medicare Allowed Amount | 380424.67 |
| Total Medicare Payment Amount | 289783.89 |
| Total Medicare Standardized Payment Amount | 301926.53 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 34871 |
| Number Of Medicare Beneficiaries With Drug Services | 252 |
| Total Drug Submitted ChargeAmount | 16761.41 |
| Total Drug Medicare AllowedAmount | 7934.31 |
| Total Drug Medicare PaymentAmount | 6088.43 |
| Total Drug Medicare Standardized Payment Amount | 6088.43 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 115 |
| Number Of Medical Services | 5283 |
| Number Of Medicare Beneficiaries With Medical Services | 3956 |
| Total Medical Submitted Charge Amount | 1143829.24 |
| Total Medical Medicare Allowed Amount | 372490.36 |
| Total Medical Medicare Payment Amount | 283695.46 |
| Total Medical Medicare Standardized Payment Amount | 295838.1 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 685 |
| Number Of Beneficiaries Age 65 to 74 | 1481 |
| Number Of Beneficiaries Age 75 to 84 | 1215 |
| Number Of Beneficiaries Age Greater 84 | 586 |
| Number Of Female Beneficiaries | 2220 |
| Number Of Male Beneficiaries | 1747 |
| Number Of Non Hispanic White Beneficiaries | 2915 |
| Number Of Black or African American Beneficiaries | 413 |
| Number Of AsianPacific Islander Beneficiaries | 72 |
| Number Of Hispanic Beneficiaries | 518 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 3049 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 918 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 26 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 46 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 59 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 2.1581 |