| National Provider Identifier [NPI]: | 1508858200 |
| Last Name Of The Provider | BURKEN |
| First Name Of The Provider | RUSSELL |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 274 BIG A ROAD |
| Street Address 2 Of The Provider | |
| City Of The Provider | TOCCOA |
| Zip Code Of The Provider | 305776002 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 103 |
| Number Of Services | 8713 |
| Number Of Medicare Beneficiaries | 1476 |
| Total Submitted Charge Amount | 1484666 |
| Total Medicare Allowed Amount | 664805.2 |
| Total Medicare Payment Amount | 490045.84 |
| Total Medicare Standardized Payment Amount | 519121.43 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 213 |
| Number Of Medicare Beneficiaries With Drug Services | 59 |
| Total Drug Submitted ChargeAmount | 5772 |
| Total Drug Medicare AllowedAmount | 4963.67 |
| Total Drug Medicare PaymentAmount | 3511.23 |
| Total Drug Medicare Standardized Payment Amount | 3511.23 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 101 |
| Number Of Medical Services | 8500 |
| Number Of Medicare Beneficiaries With Medical Services | 1476 |
| Total Medical Submitted Charge Amount | 1478894 |
| Total Medical Medicare Allowed Amount | 659841.53 |
| Total Medical Medicare Payment Amount | 486534.61 |
| Total Medical Medicare Standardized Payment Amount | 515610.2 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 66 |
| Number Of Beneficiaries Age 65 to 74 | 618 |
| Number Of Beneficiaries Age 75 to 84 | 580 |
| Number Of Beneficiaries Age Greater 84 | 212 |
| Number Of Female Beneficiaries | 660 |
| Number Of Male Beneficiaries | 816 |
| Number Of Non Hispanic White Beneficiaries | 1455 |
| 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 | 1346 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 130 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.999 |