| National Provider Identifier [NPI]: | 1922050632 |
| Last Name Of The Provider | BURCHENAL |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 213 ELM ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | STONINGTON |
| Zip Code Of The Provider | 063781165 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 35 |
| Number Of Services | 3606 |
| Number Of Medicare Beneficiaries | 913 |
| Total Submitted Charge Amount | 341190 |
| Total Medicare Allowed Amount | 273584.02 |
| Total Medicare Payment Amount | 203744.84 |
| Total Medicare Standardized Payment Amount | 194329.7 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 170 |
| Number Of Medicare Beneficiaries With Drug Services | 156 |
| Total Drug Submitted ChargeAmount | 6345 |
| Total Drug Medicare AllowedAmount | 4672.32 |
| Total Drug Medicare PaymentAmount | 4569.17 |
| Total Drug Medicare Standardized Payment Amount | 4569.17 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 3436 |
| Number Of Medicare Beneficiaries With Medical Services | 913 |
| Total Medical Submitted Charge Amount | 334845 |
| Total Medical Medicare Allowed Amount | 268911.7 |
| Total Medical Medicare Payment Amount | 199175.67 |
| Total Medical Medicare Standardized Payment Amount | 189760.53 |
| Average Age Of Beneficiaries | 79 |
| Number Of Beneficiaries Age Less65 | 33 |
| Number Of Beneficiaries Age 65 to 74 | 284 |
| Number Of Beneficiaries Age 75 to 84 | 309 |
| Number Of Beneficiaries Age Greater 84 | 287 |
| Number Of Female Beneficiaries | 568 |
| Number Of Male Beneficiaries | 345 |
| Number Of Non Hispanic White Beneficiaries | 867 |
| 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 | 29 |
| Number Of Beneficiaries With Medicare Only Entitlement | 741 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 172 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 26 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.2791 |