| National Provider Identifier [NPI]: | 1114903143 |
| Last Name Of The Provider | SIEBEN |
| First Name Of The Provider | CANDICE |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 100 ARROW SPRINGS BLVD |
| Street Address 2 Of The Provider | SUITE 2800 |
| City Of The Provider | LEBANON |
| Zip Code Of The Provider | 45036 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 32 |
| Number Of Services | 951 |
| Number Of Medicare Beneficiaries | 181 |
| Total Submitted Charge Amount | 102055 |
| Total Medicare Allowed Amount | 73305.9 |
| Total Medicare Payment Amount | 50505.68 |
| Total Medicare Standardized Payment Amount | 53226.77 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 168 |
| Number Of Medicare Beneficiaries With Drug Services | 79 |
| Total Drug Submitted ChargeAmount | 4214 |
| Total Drug Medicare AllowedAmount | 2008.52 |
| Total Drug Medicare PaymentAmount | 1929.6 |
| Total Drug Medicare Standardized Payment Amount | 1929.6 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 24 |
| Number Of Medical Services | 783 |
| Number Of Medicare Beneficiaries With Medical Services | 181 |
| Total Medical Submitted Charge Amount | 97841 |
| Total Medical Medicare Allowed Amount | 71297.38 |
| Total Medical Medicare Payment Amount | 48576.08 |
| Total Medical Medicare Standardized Payment Amount | 51297.17 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 35 |
| Number Of Beneficiaries Age 65 to 74 | 66 |
| Number Of Beneficiaries Age 75 to 84 | 56 |
| Number Of Beneficiaries Age Greater 84 | 24 |
| Number Of Female Beneficiaries | 127 |
| Number Of Male Beneficiaries | 54 |
| 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 | 147 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 34 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0278 |