| National Provider Identifier [NPI]: | 1184667909 |
| Last Name Of The Provider | BURNHAM |
| First Name Of The Provider | ASHLEY |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 209 S PORTLAND AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | RUSSELLVILLE |
| Zip Code Of The Provider | 728012339 |
| State Code Of The Provider | AR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 187 |
| Number Of Services | 7941 |
| Number Of Medicare Beneficiaries | 4004 |
| Total Submitted Charge Amount | 819102 |
| Total Medicare Allowed Amount | 217824.17 |
| Total Medicare Payment Amount | 165469.21 |
| Total Medicare Standardized Payment Amount | 178510.64 |
| 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 | 187 |
| Number Of Medical Services | 7941 |
| Number Of Medicare Beneficiaries With Medical Services | 4004 |
| Total Medical Submitted Charge Amount | 819102 |
| Total Medical Medicare Allowed Amount | 217824.17 |
| Total Medical Medicare Payment Amount | 165469.21 |
| Total Medical Medicare Standardized Payment Amount | 178510.64 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 934 |
| Number Of Beneficiaries Age 65 to 74 | 1430 |
| Number Of Beneficiaries Age 75 to 84 | 1105 |
| Number Of Beneficiaries Age Greater 84 | 535 |
| Number Of Female Beneficiaries | 2528 |
| Number Of Male Beneficiaries | 1476 |
| Number Of Non Hispanic White Beneficiaries | 3815 |
| Number Of Black or African American Beneficiaries | 67 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 71 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 22 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2674 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1330 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.3409 |