| National Provider Identifier [NPI]: | 1366429391 |
| Last Name Of The Provider | BURBIDGE |
| First Name Of The Provider | STEVEN |
| 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 | 3800 PARK NICOLLET BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | ST LOUIS PARK |
| Zip Code Of The Provider | 554162527 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 122 |
| Number Of Services | 5490 |
| Number Of Medicare Beneficiaries | 1218 |
| Total Submitted Charge Amount | 225743.5 |
| Total Medicare Allowed Amount | 93208.06 |
| Total Medicare Payment Amount | 69232.39 |
| Total Medicare Standardized Payment Amount | 71385.39 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 3829 |
| Number Of Medicare Beneficiaries With Drug Services | 61 |
| Total Drug Submitted ChargeAmount | 3261.25 |
| Total Drug Medicare AllowedAmount | 1450.47 |
| Total Drug Medicare PaymentAmount | 1113.07 |
| Total Drug Medicare Standardized Payment Amount | 1113.07 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 116 |
| Number Of Medical Services | 1661 |
| Number Of Medicare Beneficiaries With Medical Services | 1218 |
| Total Medical Submitted Charge Amount | 222482.25 |
| Total Medical Medicare Allowed Amount | 91757.59 |
| Total Medical Medicare Payment Amount | 68119.32 |
| Total Medical Medicare Standardized Payment Amount | 70272.32 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 265 |
| Number Of Beneficiaries Age 65 to 74 | 349 |
| Number Of Beneficiaries Age 75 to 84 | 325 |
| Number Of Beneficiaries Age Greater 84 | 279 |
| Number Of Female Beneficiaries | 762 |
| Number Of Male Beneficiaries | 456 |
| Number Of Non Hispanic White Beneficiaries | 1090 |
| Number Of Black or African American Beneficiaries | 73 |
| Number Of AsianPacific Islander Beneficiaries | 20 |
| Number Of Hispanic Beneficiaries | 18 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 908 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 310 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.6071 |