| National Provider Identifier [NPI]: | 1104029693 |
| Last Name Of The Provider | SUGG |
| First Name Of The Provider | KRISTOFFER |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1500 E MEDICAL CENTER DR |
| Street Address 2 Of The Provider | 2130 TAUBMAN CTR, SPC 5340 |
| City Of The Provider | ANN ARBOR |
| Zip Code Of The Provider | 481095340 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 41 |
| Number Of Services | 218 |
| Number Of Medicare Beneficiaries | 88 |
| Total Submitted Charge Amount | 20351 |
| Total Medicare Allowed Amount | 15432.98 |
| Total Medicare Payment Amount | 11242.21 |
| Total Medicare Standardized Payment Amount | 10839.69 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 29 |
| Number Of Medicare Beneficiaries With Drug Services | 14 |
| Total Drug Submitted ChargeAmount | 247 |
| Total Drug Medicare AllowedAmount | 143.23 |
| Total Drug Medicare PaymentAmount | 121.25 |
| Total Drug Medicare Standardized Payment Amount | 121.25 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 33 |
| Number Of Medical Services | 189 |
| Number Of Medicare Beneficiaries With Medical Services | 88 |
| Total Medical Submitted Charge Amount | 20104 |
| Total Medical Medicare Allowed Amount | 15289.75 |
| Total Medical Medicare Payment Amount | 11120.96 |
| Total Medical Medicare Standardized Payment Amount | 10718.44 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 33 |
| Number Of Beneficiaries Age 75 to 84 | 27 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 54 |
| Number Of Male Beneficiaries | 34 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 72 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 16 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2006 |