| National Provider Identifier [NPI]: | 1992771687 |
| Last Name Of The Provider | BURDGE |
| First Name Of The Provider | KELLY |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 104 ENDICOTT ST |
| Street Address 2 Of The Provider | SUITE 104 |
| City Of The Provider | DANVERS |
| Zip Code Of The Provider | 019233623 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nephrology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 29 |
| Number Of Services | 1520 |
| Number Of Medicare Beneficiaries | 571 |
| Total Submitted Charge Amount | 504885 |
| Total Medicare Allowed Amount | 149202.55 |
| Total Medicare Payment Amount | 110100.71 |
| Total Medicare Standardized Payment Amount | 107618.48 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 22 |
| Number Of Medicare Beneficiaries With Drug Services | 22 |
| Total Drug Submitted ChargeAmount | 795 |
| Total Drug Medicare AllowedAmount | 556.38 |
| Total Drug Medicare PaymentAmount | 545.24 |
| Total Drug Medicare Standardized Payment Amount | 545.24 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 25 |
| Number Of Medical Services | 1498 |
| Number Of Medicare Beneficiaries With Medical Services | 571 |
| Total Medical Submitted Charge Amount | 504090 |
| Total Medical Medicare Allowed Amount | 148646.17 |
| Total Medical Medicare Payment Amount | 109555.47 |
| Total Medical Medicare Standardized Payment Amount | 107073.24 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 78 |
| Number Of Beneficiaries Age 65 to 74 | 187 |
| Number Of Beneficiaries Age 75 to 84 | 206 |
| Number Of Beneficiaries Age Greater 84 | 100 |
| Number Of Female Beneficiaries | 287 |
| Number Of Male Beneficiaries | 284 |
| Number Of Non Hispanic White Beneficiaries | 513 |
| Number Of Black or African American Beneficiaries | 20 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 25 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 427 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 144 |
| Percent Of With Atrial Fibrillation | 27 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 51 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 51 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 59 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 2.7831 |