| National Provider Identifier [NPI]: | 1639275969 |
| Last Name Of The Provider | BURGOS |
| First Name Of The Provider | JORGE |
| Middle Initial Of The Provider | Y |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1815 E LAKE MEAD BLVD STE 317 |
| Street Address 2 Of The Provider | |
| City Of The Provider | N LAS VEGAS |
| Zip Code Of The Provider | 890307193 |
| State Code Of The Provider | NV |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 59 |
| Number Of Services | 1368 |
| Number Of Medicare Beneficiaries | 313 |
| Total Submitted Charge Amount | 216536.45 |
| Total Medicare Allowed Amount | 124877.8 |
| Total Medicare Payment Amount | 80241.32 |
| Total Medicare Standardized Payment Amount | 84270.91 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 47 |
| Number Of Medicare Beneficiaries With Drug Services | 42 |
| Total Drug Submitted ChargeAmount | 2088 |
| Total Drug Medicare AllowedAmount | 706.15 |
| Total Drug Medicare PaymentAmount | 680.33 |
| Total Drug Medicare Standardized Payment Amount | 680.33 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 49 |
| Number Of Medical Services | 1321 |
| Number Of Medicare Beneficiaries With Medical Services | 313 |
| Total Medical Submitted Charge Amount | 214448.45 |
| Total Medical Medicare Allowed Amount | 124171.65 |
| Total Medical Medicare Payment Amount | 79560.99 |
| Total Medical Medicare Standardized Payment Amount | 83590.58 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 80 |
| Number Of Beneficiaries Age 65 to 74 | 138 |
| Number Of Beneficiaries Age 75 to 84 | 76 |
| Number Of Beneficiaries Age Greater 84 | 19 |
| Number Of Female Beneficiaries | 190 |
| Number Of Male Beneficiaries | 123 |
| Number Of Non Hispanic White Beneficiaries | 29 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 266 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 101 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 212 |
| Percent Of With Atrial Fibrillation | 4 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 5 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 51 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.4107 |