| National Provider Identifier [NPI]: | 1568411106 |
| Last Name Of The Provider | SHULKOSKY |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 201 STATE ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | ERIE |
| Zip Code Of The Provider | 165500002 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Anesthesiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 78 |
| Number Of Services | 469 |
| Number Of Medicare Beneficiaries | 413 |
| Total Submitted Charge Amount | 535201.4 |
| Total Medicare Allowed Amount | 48763.15 |
| Total Medicare Payment Amount | 37701.52 |
| Total Medicare Standardized Payment Amount | 38034.79 |
| 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 | 78 |
| Number Of Medical Services | 469 |
| Number Of Medicare Beneficiaries With Medical Services | 413 |
| Total Medical Submitted Charge Amount | 535201.4 |
| Total Medical Medicare Allowed Amount | 48763.15 |
| Total Medical Medicare Payment Amount | 37701.52 |
| Total Medical Medicare Standardized Payment Amount | 38034.79 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 112 |
| Number Of Beneficiaries Age 65 to 74 | 170 |
| Number Of Beneficiaries Age 75 to 84 | 96 |
| Number Of Beneficiaries Age Greater 84 | 35 |
| Number Of Female Beneficiaries | 228 |
| Number Of Male Beneficiaries | 185 |
| Number Of Non Hispanic White Beneficiaries | 379 |
| Number Of Black or African American Beneficiaries | 22 |
| 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 | 285 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 128 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.7512 |