| National Provider Identifier [NPI]: | 1578519922 |
| Last Name Of The Provider | BURRIS |
| First Name Of The Provider | LARRY |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1205 S GRANGE AVE |
| Street Address 2 Of The Provider | STE 201 |
| City Of The Provider | SIOUX FALLS |
| Zip Code Of The Provider | 571050407 |
| State Code Of The Provider | SD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Critical Care (Intensivists) |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 29 |
| Number Of Services | 4107 |
| Number Of Medicare Beneficiaries | 393 |
| Total Submitted Charge Amount | 1101940.36 |
| Total Medicare Allowed Amount | 379867.98 |
| Total Medicare Payment Amount | 296259.51 |
| Total Medicare Standardized Payment Amount | 304366.01 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 29 |
| Number Of Medical Services | 4107 |
| Number Of Medicare Beneficiaries With Medical Services | 393 |
| Total Medical Submitted Charge Amount | 1101940.36 |
| Total Medical Medicare Allowed Amount | 379867.98 |
| Total Medical Medicare Payment Amount | 296259.51 |
| Total Medical Medicare Standardized Payment Amount | 304366.01 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 116 |
| Number Of Beneficiaries Age 65 to 74 | 112 |
| Number Of Beneficiaries Age 75 to 84 | 120 |
| Number Of Beneficiaries Age Greater 84 | 45 |
| Number Of Female Beneficiaries | 193 |
| Number Of Male Beneficiaries | 200 |
| Number Of Non Hispanic White Beneficiaries | 350 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 28 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 275 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 118 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 60 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 41 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 15 |
| Percent Of With Stroke | 29 |
| Average HCC Risk Score Of Beneficiaries | 2.4932 |