| National Provider Identifier [NPI]: | 1811102080 |
| Last Name Of The Provider | SULKOWSKI |
| First Name Of The Provider | GREGORY |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1169 EASTERN PKWY |
| Street Address 2 Of The Provider | TAUSTINE EYE CENTER SUITE 3427 |
| City Of The Provider | LOUISVILLE |
| Zip Code Of The Provider | 402171417 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 36 |
| Number Of Services | 4278 |
| Number Of Medicare Beneficiaries | 1243 |
| Total Submitted Charge Amount | 496332 |
| Total Medicare Allowed Amount | 383142.63 |
| Total Medicare Payment Amount | 264704.37 |
| Total Medicare Standardized Payment Amount | 288092.13 |
| 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 | 36 |
| Number Of Medical Services | 4278 |
| Number Of Medicare Beneficiaries With Medical Services | 1243 |
| Total Medical Submitted Charge Amount | 496332 |
| Total Medical Medicare Allowed Amount | 383142.63 |
| Total Medical Medicare Payment Amount | 264704.37 |
| Total Medical Medicare Standardized Payment Amount | 288092.13 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 84 |
| Number Of Beneficiaries Age 65 to 74 | 458 |
| Number Of Beneficiaries Age 75 to 84 | 470 |
| Number Of Beneficiaries Age Greater 84 | 231 |
| Number Of Female Beneficiaries | 758 |
| Number Of Male Beneficiaries | 485 |
| Number Of Non Hispanic White Beneficiaries | 1036 |
| Number Of Black or African American Beneficiaries | 178 |
| 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 | 14 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1079 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 164 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.1292 |