| National Provider Identifier [NPI]: | 1548255482 |
| Last Name Of The Provider | SUGARMAN |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D., PH.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2725 MENDOCINO AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | SANTA ROSA |
| Zip Code Of The Provider | 954032805 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 93 |
| Number Of Services | 19294 |
| Number Of Medicare Beneficiaries | 5215 |
| Total Submitted Charge Amount | 1578456 |
| Total Medicare Allowed Amount | 1053064.56 |
| Total Medicare Payment Amount | 770388.93 |
| Total Medicare Standardized Payment Amount | 671463.07 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 119 |
| Number Of Medicare Beneficiaries With Drug Services | 78 |
| Total Drug Submitted ChargeAmount | 35621 |
| Total Drug Medicare AllowedAmount | 22067.03 |
| Total Drug Medicare PaymentAmount | 15344.97 |
| Total Drug Medicare Standardized Payment Amount | 15344.97 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 91 |
| Number Of Medical Services | 19175 |
| Number Of Medicare Beneficiaries With Medical Services | 5215 |
| Total Medical Submitted Charge Amount | 1542835 |
| Total Medical Medicare Allowed Amount | 1030997.53 |
| Total Medical Medicare Payment Amount | 755043.96 |
| Total Medical Medicare Standardized Payment Amount | 656118.1 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 352 |
| Number Of Beneficiaries Age 65 to 74 | 2326 |
| Number Of Beneficiaries Age 75 to 84 | 1622 |
| Number Of Beneficiaries Age Greater 84 | 915 |
| Number Of Female Beneficiaries | 2526 |
| Number Of Male Beneficiaries | 2689 |
| Number Of Non Hispanic White Beneficiaries | 4874 |
| Number Of Black or African American Beneficiaries | 16 |
| Number Of AsianPacific Islander Beneficiaries | 26 |
| Number Of Hispanic Beneficiaries | 181 |
| Number Of American Indian Alaska Native Beneficiaries | 43 |
| Number Of Beneficiaries With Race Not Else where Classified | 75 |
| Number Of Beneficiaries With Medicare Only Entitlement | 4634 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 581 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 19 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 53 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0184 |