National Provider Identifier [NPI]: |
1043454838 |
Last Name Of The Provider |
BURNHAM |
First Name Of The Provider |
KEVIN |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4150 V ST |
Street Address 2 Of The Provider |
SUITE # 3116 |
City Of The Provider |
SACRAMENTO |
Zip Code Of The Provider |
958171460 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
22 |
Number Of Services |
517 |
Number Of Medicare Beneficiaries |
305 |
Total Submitted Charge Amount |
116188 |
Total Medicare Allowed Amount |
40739.71 |
Total Medicare Payment Amount |
31718.89 |
Total Medicare Standardized Payment Amount |
30858.74 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
66 |
Number Of Medicare Beneficiaries With Drug Services |
15 |
Total Drug Submitted ChargeAmount |
5333 |
Total Drug Medicare AllowedAmount |
2400.75 |
Total Drug Medicare PaymentAmount |
1882.22 |
Total Drug Medicare Standardized Payment Amount |
1882.22 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
17 |
Number Of Medical Services |
451 |
Number Of Medicare Beneficiaries With Medical Services |
305 |
Total Medical Submitted Charge Amount |
110855 |
Total Medical Medicare Allowed Amount |
38338.96 |
Total Medical Medicare Payment Amount |
29836.67 |
Total Medical Medicare Standardized Payment Amount |
28976.52 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
88 |
Number Of Beneficiaries Age 65 to 74 |
112 |
Number Of Beneficiaries Age 75 to 84 |
76 |
Number Of Beneficiaries Age Greater 84 |
29 |
Number Of Female Beneficiaries |
170 |
Number Of Male Beneficiaries |
135 |
Number Of Non Hispanic White Beneficiaries |
169 |
Number Of Black or African American Beneficiaries |
55 |
Number Of AsianPacific Islander Beneficiaries |
29 |
Number Of Hispanic Beneficiaries |
41 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
121 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
184 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
40 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.7622 |