| National Provider Identifier [NPI]: | 1306826656 |
| Last Name Of The Provider | SIEGEL |
| First Name Of The Provider | EUGENE |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6410A RISING SUN AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | PHILA |
| Zip Code Of The Provider | 191115229 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 25 |
| Number Of Services | 427 |
| Number Of Medicare Beneficiaries | 108 |
| Total Submitted Charge Amount | 45359 |
| Total Medicare Allowed Amount | 30394.88 |
| Total Medicare Payment Amount | 21730.1 |
| Total Medicare Standardized Payment Amount | 20753.21 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 70 |
| Number Of Medicare Beneficiaries With Drug Services | 38 |
| Total Drug Submitted ChargeAmount | 1477 |
| Total Drug Medicare AllowedAmount | 779.68 |
| Total Drug Medicare PaymentAmount | 732.7 |
| Total Drug Medicare Standardized Payment Amount | 732.7 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 17 |
| Number Of Medical Services | 357 |
| Number Of Medicare Beneficiaries With Medical Services | 108 |
| Total Medical Submitted Charge Amount | 43882 |
| Total Medical Medicare Allowed Amount | 29615.2 |
| Total Medical Medicare Payment Amount | 20997.4 |
| Total Medical Medicare Standardized Payment Amount | 20020.51 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 34 |
| Number Of Beneficiaries Age 65 to 74 | 55 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 58 |
| Number Of Male Beneficiaries | 50 |
| Number Of Non Hispanic White Beneficiaries | 84 |
| 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 | 61 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 47 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1438 |