| National Provider Identifier [NPI]: | 1174593446 |
| Last Name Of The Provider | BURCH |
| First Name Of The Provider | MARY |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 601 W MCKENNON ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | CLARKSVILLE |
| Zip Code Of The Provider | 728303523 |
| State Code Of The Provider | AR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 124 |
| Number Of Services | 3668 |
| Number Of Medicare Beneficiaries | 635 |
| Total Submitted Charge Amount | 251989 |
| Total Medicare Allowed Amount | 170491.7 |
| Total Medicare Payment Amount | 117928.52 |
| Total Medicare Standardized Payment Amount | 126310.5 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 192 |
| Number Of Medicare Beneficiaries With Drug Services | 168 |
| Total Drug Submitted ChargeAmount | 3680 |
| Total Drug Medicare AllowedAmount | 2535.74 |
| Total Drug Medicare PaymentAmount | 2439.2 |
| Total Drug Medicare Standardized Payment Amount | 2439.2 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 112 |
| Number Of Medical Services | 3476 |
| Number Of Medicare Beneficiaries With Medical Services | 635 |
| Total Medical Submitted Charge Amount | 248309 |
| Total Medical Medicare Allowed Amount | 167955.96 |
| Total Medical Medicare Payment Amount | 115489.32 |
| Total Medical Medicare Standardized Payment Amount | 123871.3 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 131 |
| Number Of Beneficiaries Age 65 to 74 | 232 |
| Number Of Beneficiaries Age 75 to 84 | 181 |
| Number Of Beneficiaries Age Greater 84 | 91 |
| Number Of Female Beneficiaries | 428 |
| Number Of Male Beneficiaries | 207 |
| Number Of Non Hispanic White Beneficiaries | 619 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 444 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 191 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 2 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 41 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 27 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.0347 |