National Provider Identifier [NPI]: |
1780671537 |
Last Name Of The Provider |
SIDDIQI |
First Name Of The Provider |
SEEMEEN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2050 W SOUTHERN AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
APACHE JUNCTION |
Zip Code Of The Provider |
851207305 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
1530 |
Number Of Medicare Beneficiaries |
311 |
Total Submitted Charge Amount |
275309 |
Total Medicare Allowed Amount |
155653.45 |
Total Medicare Payment Amount |
121461.01 |
Total Medicare Standardized Payment Amount |
122108.57 |
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 |
21 |
Number Of Medical Services |
1530 |
Number Of Medicare Beneficiaries With Medical Services |
311 |
Total Medical Submitted Charge Amount |
275309 |
Total Medical Medicare Allowed Amount |
155653.45 |
Total Medical Medicare Payment Amount |
121461.01 |
Total Medical Medicare Standardized Payment Amount |
122108.57 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
39 |
Number Of Beneficiaries Age 65 to 74 |
113 |
Number Of Beneficiaries Age 75 to 84 |
101 |
Number Of Beneficiaries Age Greater 84 |
58 |
Number Of Female Beneficiaries |
167 |
Number Of Male Beneficiaries |
144 |
Number Of Non Hispanic White Beneficiaries |
273 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
17 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
235 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
76 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
42 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
37 |
Percent Of With Chronic Kidney Disease |
50 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
54 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
63 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
36 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
1.9192 |