| National Provider Identifier [NPI]: | 1669431367 |
| Last Name Of The Provider | BURSZTYN |
| First Name Of The Provider | ENRIQUE |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 520 S 7TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | VINCENNES |
| Zip Code Of The Provider | 475911038 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 195 |
| Number Of Services | 6960 |
| Number Of Medicare Beneficiaries | 3601 |
| Total Submitted Charge Amount | 1309650 |
| Total Medicare Allowed Amount | 226386.93 |
| Total Medicare Payment Amount | 177714.36 |
| Total Medicare Standardized Payment Amount | 185640.37 |
| 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 | 195 |
| Number Of Medical Services | 6960 |
| Number Of Medicare Beneficiaries With Medical Services | 3601 |
| Total Medical Submitted Charge Amount | 1309650 |
| Total Medical Medicare Allowed Amount | 226386.93 |
| Total Medical Medicare Payment Amount | 177714.36 |
| Total Medical Medicare Standardized Payment Amount | 185640.37 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 642 |
| Number Of Beneficiaries Age 65 to 74 | 1251 |
| Number Of Beneficiaries Age 75 to 84 | 1185 |
| Number Of Beneficiaries Age Greater 84 | 523 |
| Number Of Female Beneficiaries | 2165 |
| Number Of Male Beneficiaries | 1436 |
| Number Of Non Hispanic White Beneficiaries | 3530 |
| Number Of Black or African American Beneficiaries | 26 |
| 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 | 23 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2627 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 974 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.5747 |