| National Provider Identifier [NPI]: | 1821031212 |
| Last Name Of The Provider | SIEGAL |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 15340 JOG RD |
| Street Address 2 Of The Provider | SUITE 210 |
| City Of The Provider | DELRAY BEACH |
| Zip Code Of The Provider | 334462170 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 30 |
| Number Of Services | 6913 |
| Number Of Medicare Beneficiaries | 1381 |
| Total Submitted Charge Amount | 1105055 |
| Total Medicare Allowed Amount | 689971.6 |
| Total Medicare Payment Amount | 516409.09 |
| Total Medicare Standardized Payment Amount | 490135.38 |
| 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 | 30 |
| Number Of Medical Services | 6913 |
| Number Of Medicare Beneficiaries With Medical Services | 1381 |
| Total Medical Submitted Charge Amount | 1105055 |
| Total Medical Medicare Allowed Amount | 689971.6 |
| Total Medical Medicare Payment Amount | 516409.09 |
| Total Medical Medicare Standardized Payment Amount | 490135.38 |
| Average Age Of Beneficiaries | 79 |
| Number Of Beneficiaries Age Less65 | 15 |
| Number Of Beneficiaries Age 65 to 74 | 405 |
| Number Of Beneficiaries Age 75 to 84 | 611 |
| Number Of Beneficiaries Age Greater 84 | 350 |
| Number Of Female Beneficiaries | 830 |
| Number Of Male Beneficiaries | 551 |
| Number Of Non Hispanic White Beneficiaries | 1343 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 13 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1364 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 17 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2846 |