| National Provider Identifier [NPI]: | 1447424239 |
| Last Name Of The Provider | SIDDIQI |
| First Name Of The Provider | ASMA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MBBS |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3024 SNELLING AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | MINNEAPOLIS |
| Zip Code Of The Provider | 554061911 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 25 |
| Number Of Services | 340 |
| Number Of Medicare Beneficiaries | 67 |
| Total Submitted Charge Amount | 21311 |
| Total Medicare Allowed Amount | 9434.65 |
| Total Medicare Payment Amount | 7192.47 |
| Total Medicare Standardized Payment Amount | 7398.39 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 164 |
| Number Of Medicare Beneficiaries With Drug Services | 15 |
| Total Drug Submitted ChargeAmount | 433 |
| Total Drug Medicare AllowedAmount | 249.92 |
| Total Drug Medicare PaymentAmount | 236.34 |
| Total Drug Medicare Standardized Payment Amount | 236.34 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 20 |
| Number Of Medical Services | 176 |
| Number Of Medicare Beneficiaries With Medical Services | 67 |
| Total Medical Submitted Charge Amount | 20878 |
| Total Medical Medicare Allowed Amount | 9184.73 |
| Total Medical Medicare Payment Amount | 6956.13 |
| Total Medical Medicare Standardized Payment Amount | 7162.05 |
| Average Age Of Beneficiaries | 64 |
| Number Of Beneficiaries Age Less65 | 31 |
| Number Of Beneficiaries Age 65 to 74 | 20 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 44 |
| Number Of Male Beneficiaries | 23 |
| Number Of Non Hispanic White Beneficiaries | 37 |
| 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 | 36 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 31 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 31 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 27 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2886 |