| National Provider Identifier [NPI]: | 1114997137 |
| Last Name Of The Provider | SUGIN |
| First Name Of The Provider | STEPHANIE |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1201 W MAIN ST |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | WATERBURY |
| Zip Code Of The Provider | 067083105 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 45 |
| Number Of Services | 8950 |
| Number Of Medicare Beneficiaries | 741 |
| Total Submitted Charge Amount | 3763326.03 |
| Total Medicare Allowed Amount | 2047553.2 |
| Total Medicare Payment Amount | 1580259.88 |
| Total Medicare Standardized Payment Amount | 1551763.05 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 3890 |
| Number Of Medicare Beneficiaries With Drug Services | 229 |
| Total Drug Submitted ChargeAmount | 1661759 |
| Total Drug Medicare AllowedAmount | 1513852.56 |
| Total Drug Medicare PaymentAmount | 1181923.36 |
| Total Drug Medicare Standardized Payment Amount | 1181923.36 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 38 |
| Number Of Medical Services | 5060 |
| Number Of Medicare Beneficiaries With Medical Services | 740 |
| Total Medical Submitted Charge Amount | 2101567.03 |
| Total Medical Medicare Allowed Amount | 533700.64 |
| Total Medical Medicare Payment Amount | 398336.52 |
| Total Medical Medicare Standardized Payment Amount | 369839.69 |
| Average Age Of Beneficiaries | 79 |
| Number Of Beneficiaries Age Less65 | 21 |
| Number Of Beneficiaries Age 65 to 74 | 230 |
| Number Of Beneficiaries Age 75 to 84 | 245 |
| Number Of Beneficiaries Age Greater 84 | 245 |
| Number Of Female Beneficiaries | 472 |
| Number Of Male Beneficiaries | 269 |
| Number Of Non Hispanic White Beneficiaries | 676 |
| Number Of Black or African American Beneficiaries | 20 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 26 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 607 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 134 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.4275 |