| National Provider Identifier [NPI]: | 1861458150 |
| Last Name Of The Provider | KUKLINSKI |
| First Name Of The Provider | LOUISE |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1244 FT WASHINGTON AVE |
| Street Address 2 Of The Provider | SUITE E2 FAMILY PRACTICE ASSOCIATES OF UPPER DUBLIN |
| City Of The Provider | FT WASHINGTON |
| Zip Code Of The Provider | 19034 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 29 |
| Number Of Services | 843 |
| Number Of Medicare Beneficiaries | 240 |
| Total Submitted Charge Amount | 75885 |
| Total Medicare Allowed Amount | 56890.35 |
| Total Medicare Payment Amount | 43960.81 |
| Total Medicare Standardized Payment Amount | 42162.24 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 106 |
| Number Of Medicare Beneficiaries With Drug Services | 94 |
| Total Drug Submitted ChargeAmount | 4418 |
| Total Drug Medicare AllowedAmount | 3686.49 |
| Total Drug Medicare PaymentAmount | 3605.68 |
| Total Drug Medicare Standardized Payment Amount | 3605.68 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 22 |
| Number Of Medical Services | 737 |
| Number Of Medicare Beneficiaries With Medical Services | 240 |
| Total Medical Submitted Charge Amount | 71467 |
| Total Medical Medicare Allowed Amount | 53203.86 |
| Total Medical Medicare Payment Amount | 40355.13 |
| Total Medical Medicare Standardized Payment Amount | 38556.56 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 15 |
| Number Of Beneficiaries Age 65 to 74 | 138 |
| Number Of Beneficiaries Age 75 to 84 | 62 |
| Number Of Beneficiaries Age Greater 84 | 25 |
| Number Of Female Beneficiaries | 192 |
| Number Of Male Beneficiaries | 48 |
| Number Of Non Hispanic White Beneficiaries | 209 |
| Number Of Black or African American Beneficiaries | 20 |
| 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 | 6 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 5 |
| Percent Of With Chronic Kidney Disease | 9 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 17 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 50 |
| Percent Of With Ischemic Heart Disease | 15 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7627 |