National Provider Identifier [NPI]: |
1518954742 |
Last Name Of The Provider |
SUGALSKI |
First Name Of The Provider |
THOMAS |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
PHD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
264 E BROAD ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
BETHLEHEM |
Zip Code Of The Provider |
180186224 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Clinical Psychologist |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
5 |
Number Of Services |
961 |
Number Of Medicare Beneficiaries |
204 |
Total Submitted Charge Amount |
125970 |
Total Medicare Allowed Amount |
92027.73 |
Total Medicare Payment Amount |
69495.21 |
Total Medicare Standardized Payment Amount |
51826.88 |
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 |
5 |
Number Of Medical Services |
961 |
Number Of Medicare Beneficiaries With Medical Services |
204 |
Total Medical Submitted Charge Amount |
125970 |
Total Medical Medicare Allowed Amount |
92027.73 |
Total Medical Medicare Payment Amount |
69495.21 |
Total Medical Medicare Standardized Payment Amount |
51826.88 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
50 |
Number Of Beneficiaries Age 65 to 74 |
54 |
Number Of Beneficiaries Age 75 to 84 |
67 |
Number Of Beneficiaries Age Greater 84 |
33 |
Number Of Female Beneficiaries |
99 |
Number Of Male Beneficiaries |
105 |
Number Of Non Hispanic White Beneficiaries |
183 |
Number Of Black or African American Beneficiaries |
|
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 |
157 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
47 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
59 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
46 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
69 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
52 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
30 |
Percent Of With Stroke |
20 |
Average HCC Risk Score Of Beneficiaries |
2.1169 |