| National Provider Identifier [NPI]: | 1053300509 |
| Last Name Of The Provider | KULESZA |
| First Name Of The Provider | GREGORY |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 264 W MAPLE RD |
| Street Address 2 Of The Provider | #200 |
| City Of The Provider | TROY |
| Zip Code Of The Provider | 480845435 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Gastroenterology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 52 |
| Number Of Services | 3531 |
| Number Of Medicare Beneficiaries | 635 |
| Total Submitted Charge Amount | 578337 |
| Total Medicare Allowed Amount | 335141.49 |
| Total Medicare Payment Amount | 258847.16 |
| Total Medicare Standardized Payment Amount | 250764.72 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
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| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 73 |
| Number Of Beneficiaries Age 65 to 74 | 242 |
| Number Of Beneficiaries Age 75 to 84 | 209 |
| Number Of Beneficiaries Age Greater 84 | 111 |
| Number Of Female Beneficiaries | 376 |
| Number Of Male Beneficiaries | 259 |
| Number Of Non Hispanic White Beneficiaries | 535 |
| Number Of Black or African American Beneficiaries | 78 |
| 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 | 11 |
| Number Of Beneficiaries With Medicare Only Entitlement | 571 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 64 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 57 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.8315 |