| National Provider Identifier [NPI]: | 1891883955 |
| Last Name Of The Provider | PONHOLD |
| First Name Of The Provider | SIEGHART |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | M.D |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3300 E SOUTH ST |
| Street Address 2 Of The Provider | SUITE 305 |
| City Of The Provider | LAKEWOOD |
| Zip Code Of The Provider | 908054549 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 25 |
| Number Of Services | 4667 |
| Number Of Medicare Beneficiaries | 305 |
| Total Submitted Charge Amount | 556809.95 |
| Total Medicare Allowed Amount | 429085.14 |
| Total Medicare Payment Amount | 327393.65 |
| Total Medicare Standardized Payment Amount | 311946.25 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 33 |
| Number Of Medicare Beneficiaries With Drug Services | 30 |
| Total Drug Submitted ChargeAmount | 1155 |
| Total Drug Medicare AllowedAmount | 1096.56 |
| Total Drug Medicare PaymentAmount | 1074.54 |
| Total Drug Medicare Standardized Payment Amount | 1074.54 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 24 |
| Number Of Medical Services | 4634 |
| Number Of Medicare Beneficiaries With Medical Services | 305 |
| Total Medical Submitted Charge Amount | 555654.95 |
| Total Medical Medicare Allowed Amount | 427988.58 |
| Total Medical Medicare Payment Amount | 326319.11 |
| Total Medical Medicare Standardized Payment Amount | 310871.71 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 60 |
| Number Of Beneficiaries Age 65 to 74 | 95 |
| Number Of Beneficiaries Age 75 to 84 | 79 |
| Number Of Beneficiaries Age Greater 84 | 71 |
| Number Of Female Beneficiaries | 161 |
| Number Of Male Beneficiaries | 144 |
| Number Of Non Hispanic White Beneficiaries | 179 |
| Number Of Black or African American Beneficiaries | 42 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 72 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 118 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 187 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 46 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 54 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 60 |
| Percent Of With Depression | 49 |
| Percent Of With Diabetes | 54 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 64 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 69 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 36 |
| Percent Of With Stroke | 20 |
| Average HCC Risk Score Of Beneficiaries | 2.7088 |