| National Provider Identifier [NPI]: | 1467410613 |
| Last Name Of The Provider | BURGOYNE |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 515 MINOR AVE |
| Street Address 2 Of The Provider | SUITE 140 |
| City Of The Provider | SEATTLE |
| Zip Code Of The Provider | 98104 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Otolaryngology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 96 |
| Number Of Services | 4205 |
| Number Of Medicare Beneficiaries | 534 |
| Total Submitted Charge Amount | 403797 |
| Total Medicare Allowed Amount | 155486.55 |
| Total Medicare Payment Amount | 113942.09 |
| Total Medicare Standardized Payment Amount | 105808.75 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 1699 |
| Number Of Medicare Beneficiaries With Drug Services | 21 |
| Total Drug Submitted ChargeAmount | 2161 |
| Total Drug Medicare AllowedAmount | 411.97 |
| Total Drug Medicare PaymentAmount | 322.95 |
| Total Drug Medicare Standardized Payment Amount | 322.95 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 91 |
| Number Of Medical Services | 2506 |
| Number Of Medicare Beneficiaries With Medical Services | 534 |
| Total Medical Submitted Charge Amount | 401636 |
| Total Medical Medicare Allowed Amount | 155074.58 |
| Total Medical Medicare Payment Amount | 113619.14 |
| Total Medical Medicare Standardized Payment Amount | 105485.8 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 62 |
| Number Of Beneficiaries Age 65 to 74 | 223 |
| Number Of Beneficiaries Age 75 to 84 | 169 |
| Number Of Beneficiaries Age Greater 84 | 80 |
| Number Of Female Beneficiaries | 309 |
| Number Of Male Beneficiaries | 225 |
| Number Of Non Hispanic White Beneficiaries | 418 |
| Number Of Black or African American Beneficiaries | 38 |
| Number Of AsianPacific Islander Beneficiaries | 51 |
| Number Of Hispanic Beneficiaries | 14 |
| 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 | 87 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 17 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 55 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.194 |