| National Provider Identifier [NPI]: | 1982685897 |
| Last Name Of The Provider | BURNHAM |
| First Name Of The Provider | FAYE |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | RNC, ARNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 550 POPE AVE |
| Street Address 2 Of The Provider | MUNSON ARMY HEALTH CENTER?ATTN:MCXN-COD/EDITH COTTON |
| City Of The Provider | FORT LEAVENWORTH |
| Zip Code Of The Provider | 660272332 |
| State Code Of The Provider | KS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 18 |
| Number Of Services | 1912 |
| Number Of Medicare Beneficiaries | 116 |
| Total Submitted Charge Amount | 62195.37 |
| Total Medicare Allowed Amount | 55213.57 |
| Total Medicare Payment Amount | 42275.1 |
| Total Medicare Standardized Payment Amount | 43525.22 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 1753 |
| Number Of Medicare Beneficiaries With Drug Services | 42 |
| Total Drug Submitted ChargeAmount | 50852.57 |
| Total Drug Medicare AllowedAmount | 47298.95 |
| Total Drug Medicare PaymentAmount | 37280.91 |
| Total Drug Medicare Standardized Payment Amount | 37280.91 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 14 |
| Number Of Medical Services | 159 |
| Number Of Medicare Beneficiaries With Medical Services | 116 |
| Total Medical Submitted Charge Amount | 11342.8 |
| Total Medical Medicare Allowed Amount | 7914.62 |
| Total Medical Medicare Payment Amount | 4994.19 |
| Total Medical Medicare Standardized Payment Amount | 6244.31 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 69 |
| Number Of Beneficiaries Age 75 to 84 | 30 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 80 |
| Number Of Male Beneficiaries | 36 |
| Number Of Non Hispanic White Beneficiaries | 96 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 10 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 19 |
| Percent Of With Hyperlipidemia | 42 |
| Percent Of With Hypertension | 48 |
| Percent Of With Ischemic Heart Disease | 20 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7478 |