National Provider Identifier [NPI]: |
1538269154 |
Last Name Of The Provider |
SUGAR |
First Name Of The Provider |
JOEL |
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 |
1740 W TAYLOR ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606127232 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
24 |
Number Of Services |
694 |
Number Of Medicare Beneficiaries |
432 |
Total Submitted Charge Amount |
228451.5 |
Total Medicare Allowed Amount |
63509.7 |
Total Medicare Payment Amount |
45994.55 |
Total Medicare Standardized Payment Amount |
42096.11 |
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 |
24 |
Number Of Medical Services |
694 |
Number Of Medicare Beneficiaries With Medical Services |
432 |
Total Medical Submitted Charge Amount |
228451.5 |
Total Medical Medicare Allowed Amount |
63509.7 |
Total Medical Medicare Payment Amount |
45994.55 |
Total Medical Medicare Standardized Payment Amount |
42096.11 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
38 |
Number Of Beneficiaries Age 65 to 74 |
175 |
Number Of Beneficiaries Age 75 to 84 |
144 |
Number Of Beneficiaries Age Greater 84 |
75 |
Number Of Female Beneficiaries |
262 |
Number Of Male Beneficiaries |
170 |
Number Of Non Hispanic White Beneficiaries |
308 |
Number Of Black or African American Beneficiaries |
49 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
43 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
381 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
51 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0825 |