| National Provider Identifier [NPI]: | 1386677698 |
| Last Name Of The Provider | BURNETT |
| First Name Of The Provider | ANTONIO |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1675 E MAIN ST # 328 |
| Street Address 2 Of The Provider | |
| City Of The Provider | KENT |
| Zip Code Of The Provider | 442405818 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 184 |
| Number Of Services | 8051 |
| Number Of Medicare Beneficiaries | 3807 |
| Total Submitted Charge Amount | 956118 |
| Total Medicare Allowed Amount | 229301.7 |
| Total Medicare Payment Amount | 176122.45 |
| Total Medicare Standardized Payment Amount | 182411.66 |
| 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 | 184 |
| Number Of Medical Services | 8051 |
| Number Of Medicare Beneficiaries With Medical Services | 3807 |
| Total Medical Submitted Charge Amount | 956118 |
| Total Medical Medicare Allowed Amount | 229301.7 |
| Total Medical Medicare Payment Amount | 176122.45 |
| Total Medical Medicare Standardized Payment Amount | 182411.66 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 884 |
| Number Of Beneficiaries Age 65 to 74 | 1136 |
| Number Of Beneficiaries Age 75 to 84 | 968 |
| Number Of Beneficiaries Age Greater 84 | 819 |
| Number Of Female Beneficiaries | 2178 |
| Number Of Male Beneficiaries | 1629 |
| Number Of Non Hispanic White Beneficiaries | 3185 |
| Number Of Black or African American Beneficiaries | 495 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 82 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 32 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2514 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1293 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.0405 |