| National Provider Identifier [NPI]: | 1598735896 |
| Last Name Of The Provider | BURROUGHS |
| First Name Of The Provider | KIM |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 677 N WILMOT RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | TUCSON |
| Zip Code Of The Provider | 857112701 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 83 |
| Number Of Services | 12136 |
| Number Of Medicare Beneficiaries | 1995 |
| Total Submitted Charge Amount | 1977411 |
| Total Medicare Allowed Amount | 394719.7 |
| Total Medicare Payment Amount | 298825.28 |
| Total Medicare Standardized Payment Amount | 307698.19 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 9333 |
| Number Of Medicare Beneficiaries With Drug Services | 314 |
| Total Drug Submitted ChargeAmount | 31453 |
| Total Drug Medicare AllowedAmount | 9689.89 |
| Total Drug Medicare PaymentAmount | 7501.34 |
| Total Drug Medicare Standardized Payment Amount | 7501.34 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 79 |
| Number Of Medical Services | 2803 |
| Number Of Medicare Beneficiaries With Medical Services | 1993 |
| Total Medical Submitted Charge Amount | 1945958 |
| Total Medical Medicare Allowed Amount | 385029.81 |
| Total Medical Medicare Payment Amount | 291323.94 |
| Total Medical Medicare Standardized Payment Amount | 300196.85 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 201 |
| Number Of Beneficiaries Age 65 to 74 | 778 |
| Number Of Beneficiaries Age 75 to 84 | 651 |
| Number Of Beneficiaries Age Greater 84 | 365 |
| Number Of Female Beneficiaries | 1178 |
| Number Of Male Beneficiaries | 817 |
| Number Of Non Hispanic White Beneficiaries | 1734 |
| Number Of Black or African American Beneficiaries | 45 |
| Number Of AsianPacific Islander Beneficiaries | 19 |
| Number Of Hispanic Beneficiaries | 162 |
| Number Of American Indian Alaska Native Beneficiaries | 17 |
| Number Of Beneficiaries With Race Not Else where Classified | 18 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1744 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 251 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 17 |
| Average HCC Risk Score Of Beneficiaries | 1.4253 |