| National Provider Identifier [NPI]: | 1124062757 |
| Last Name Of The Provider | BURK |
| First Name Of The Provider | TERRY |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6800 STATE ROUTE 162 |
| Street Address 2 Of The Provider | ANDERSON HOSPITAL DEPT OF RADIOLOGY |
| City Of The Provider | MARYVILLE |
| Zip Code Of The Provider | 620621000 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 139 |
| Number Of Services | 3433 |
| Number Of Medicare Beneficiaries | 1981 |
| Total Submitted Charge Amount | 315586 |
| Total Medicare Allowed Amount | 79587.01 |
| Total Medicare Payment Amount | 63140.76 |
| Total Medicare Standardized Payment Amount | 62152.16 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 139 |
| Number Of Medical Services | 3433 |
| Number Of Medicare Beneficiaries With Medical Services | 1981 |
| Total Medical Submitted Charge Amount | 315586 |
| Total Medical Medicare Allowed Amount | 79587.01 |
| Total Medical Medicare Payment Amount | 63140.76 |
| Total Medical Medicare Standardized Payment Amount | 62152.16 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 279 |
| Number Of Beneficiaries Age 65 to 74 | 779 |
| Number Of Beneficiaries Age 75 to 84 | 618 |
| Number Of Beneficiaries Age Greater 84 | 305 |
| Number Of Female Beneficiaries | 1347 |
| Number Of Male Beneficiaries | 634 |
| Number Of Non Hispanic White Beneficiaries | 1859 |
| Number Of Black or African American Beneficiaries | 73 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 34 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1588 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 393 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.416 |