| National Provider Identifier [NPI]: | 1558351049 |
| Last Name Of The Provider | KULWICKI |
| First Name Of The Provider | KEVIN |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4780 N JOSEY LN |
| Street Address 2 Of The Provider | |
| City Of The Provider | CARROLLTON |
| Zip Code Of The Provider | 750104615 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 61 |
| Number Of Services | 859 |
| Number Of Medicare Beneficiaries | 126 |
| Total Submitted Charge Amount | 308942.08 |
| Total Medicare Allowed Amount | 67207.67 |
| Total Medicare Payment Amount | 51545.12 |
| Total Medicare Standardized Payment Amount | 54325.75 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 167 |
| Number Of Medicare Beneficiaries With Drug Services | 27 |
| Total Drug Submitted ChargeAmount | 733.5 |
| Total Drug Medicare AllowedAmount | 318.64 |
| Total Drug Medicare PaymentAmount | 238.4 |
| Total Drug Medicare Standardized Payment Amount | 238.4 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 59 |
| Number Of Medical Services | 692 |
| Number Of Medicare Beneficiaries With Medical Services | 126 |
| Total Medical Submitted Charge Amount | 308208.58 |
| Total Medical Medicare Allowed Amount | 66889.03 |
| Total Medical Medicare Payment Amount | 51306.72 |
| Total Medical Medicare Standardized Payment Amount | 54087.35 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 20 |
| Number Of Beneficiaries Age 65 to 74 | 54 |
| Number Of Beneficiaries Age 75 to 84 | 31 |
| Number Of Beneficiaries Age Greater 84 | 21 |
| Number Of Female Beneficiaries | 84 |
| Number Of Male Beneficiaries | 42 |
| Number Of Non Hispanic White Beneficiaries | 103 |
| 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 | 103 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 23 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 56 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2817 |