| National Provider Identifier [NPI]: | 1861776163 |
| Last Name Of The Provider | BURNSED |
| First Name Of The Provider | KIMBERLY |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | A.R.N.P. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 100 NORTH MAIN STREET |
| Street Address 2 Of The Provider | FLORIDA STATE HOSPITAL |
| City Of The Provider | CHATTAHOOCHEE |
| Zip Code Of The Provider | 323241000 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 6 |
| Number Of Services | 2018 |
| Number Of Medicare Beneficiaries | 292 |
| Total Submitted Charge Amount | 188490 |
| Total Medicare Allowed Amount | 132416.77 |
| Total Medicare Payment Amount | 103817.05 |
| Total Medicare Standardized Payment Amount | 121855.16 |
| 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 | 6 |
| Number Of Medical Services | 2018 |
| Number Of Medicare Beneficiaries With Medical Services | 292 |
| Total Medical Submitted Charge Amount | 188490 |
| Total Medical Medicare Allowed Amount | 132416.77 |
| Total Medical Medicare Payment Amount | 103817.05 |
| Total Medical Medicare Standardized Payment Amount | 121855.16 |
| Average Age Of Beneficiaries | 80 |
| Number Of Beneficiaries Age Less65 | 27 |
| Number Of Beneficiaries Age 65 to 74 | 54 |
| Number Of Beneficiaries Age 75 to 84 | 93 |
| Number Of Beneficiaries Age Greater 84 | 118 |
| Number Of Female Beneficiaries | 204 |
| Number Of Male Beneficiaries | 88 |
| Number Of Non Hispanic White Beneficiaries | 225 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 35 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 257 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 75 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 46 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 61 |
| Percent Of With Diabetes | 54 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 39 |
| Percent Of With Stroke | 17 |
| Average HCC Risk Score Of Beneficiaries | 1.9382 |