| National Provider Identifier [NPI]: | 1083694087 |
| Last Name Of The Provider | BURKEMPER |
| First Name Of The Provider | NICOLE |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1402 S GRAND BLVD |
| Street Address 2 Of The Provider | DEPARTMENT OF DERMATOLOGY |
| City Of The Provider | SAINT LOUIS |
| Zip Code Of The Provider | 631041004 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 47 |
| Number Of Services | 6302 |
| Number Of Medicare Beneficiaries | 2463 |
| Total Submitted Charge Amount | 834522 |
| Total Medicare Allowed Amount | 399271.96 |
| Total Medicare Payment Amount | 295343.4 |
| Total Medicare Standardized Payment Amount | 253860.61 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 42 |
| Number Of Medicare Beneficiaries With Drug Services | 15 |
| Total Drug Submitted ChargeAmount | 168 |
| Total Drug Medicare AllowedAmount | 74.54 |
| Total Drug Medicare PaymentAmount | 54.09 |
| Total Drug Medicare Standardized Payment Amount | 54.09 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 46 |
| Number Of Medical Services | 6260 |
| Number Of Medicare Beneficiaries With Medical Services | 2463 |
| Total Medical Submitted Charge Amount | 834354 |
| Total Medical Medicare Allowed Amount | 399197.42 |
| Total Medical Medicare Payment Amount | 295289.31 |
| Total Medical Medicare Standardized Payment Amount | 253806.52 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 309 |
| Number Of Beneficiaries Age 65 to 74 | 1061 |
| Number Of Beneficiaries Age 75 to 84 | 742 |
| Number Of Beneficiaries Age Greater 84 | 351 |
| Number Of Female Beneficiaries | 1116 |
| Number Of Male Beneficiaries | 1347 |
| Number Of Non Hispanic White Beneficiaries | 2271 |
| Number Of Black or African American Beneficiaries | 134 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 12 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 35 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2143 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 320 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1669 |