| National Provider Identifier [NPI]: | 1972565026 |
| Last Name Of The Provider | BURGESON |
| First Name Of The Provider | MARY |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 407 E 22ND ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | HUNTINGBURG |
| Zip Code Of The Provider | 475428964 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 41 |
| Number Of Services | 3022 |
| Number Of Medicare Beneficiaries | 650 |
| Total Submitted Charge Amount | 299003.25 |
| Total Medicare Allowed Amount | 169357.12 |
| Total Medicare Payment Amount | 113861.62 |
| Total Medicare Standardized Payment Amount | 120875.1 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 568 |
| Number Of Medicare Beneficiaries With Drug Services | 146 |
| Total Drug Submitted ChargeAmount | 17742 |
| Total Drug Medicare AllowedAmount | 2931.34 |
| Total Drug Medicare PaymentAmount | 2780.65 |
| Total Drug Medicare Standardized Payment Amount | 2780.65 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 32 |
| Number Of Medical Services | 2454 |
| Number Of Medicare Beneficiaries With Medical Services | 650 |
| Total Medical Submitted Charge Amount | 281261.25 |
| Total Medical Medicare Allowed Amount | 166425.78 |
| Total Medical Medicare Payment Amount | 111080.97 |
| Total Medical Medicare Standardized Payment Amount | 118094.45 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 104 |
| Number Of Beneficiaries Age 65 to 74 | 238 |
| Number Of Beneficiaries Age 75 to 84 | 181 |
| Number Of Beneficiaries Age Greater 84 | 127 |
| Number Of Female Beneficiaries | 467 |
| Number Of Male Beneficiaries | 183 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 447 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 203 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 28 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 16 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.1516 |