| National Provider Identifier [NPI]: | 1891730636 |
| Last Name Of The Provider | KULCZYCKI |
| First Name Of The Provider | JAMES |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1560 E CHEVY CHASE DR |
| Street Address 2 Of The Provider | 410 |
| City Of The Provider | GLENDALE |
| Zip Code Of The Provider | 912064197 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 56 |
| Number Of Services | 7390 |
| Number Of Medicare Beneficiaries | 1592 |
| Total Submitted Charge Amount | 901102 |
| Total Medicare Allowed Amount | 553202.38 |
| Total Medicare Payment Amount | 413426.38 |
| Total Medicare Standardized Payment Amount | 353928.17 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 1727 |
| Number Of Medicare Beneficiaries With Drug Services | 51 |
| Total Drug Submitted ChargeAmount | 8446 |
| Total Drug Medicare AllowedAmount | 4325.81 |
| Total Drug Medicare PaymentAmount | 3391.45 |
| Total Drug Medicare Standardized Payment Amount | 3391.45 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 52 |
| Number Of Medical Services | 5663 |
| Number Of Medicare Beneficiaries With Medical Services | 1592 |
| Total Medical Submitted Charge Amount | 892656 |
| Total Medical Medicare Allowed Amount | 548876.57 |
| Total Medical Medicare Payment Amount | 410034.93 |
| Total Medical Medicare Standardized Payment Amount | 350536.72 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 153 |
| Number Of Beneficiaries Age 65 to 74 | 488 |
| Number Of Beneficiaries Age 75 to 84 | 519 |
| Number Of Beneficiaries Age Greater 84 | 432 |
| Number Of Female Beneficiaries | 941 |
| Number Of Male Beneficiaries | 651 |
| Number Of Non Hispanic White Beneficiaries | 1136 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 132 |
| Number Of Hispanic Beneficiaries | 227 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 59 |
| Number Of Beneficiaries With Medicare Only Entitlement | 711 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 881 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 26 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 2.0895 |