| National Provider Identifier [NPI]: | 1023022399 |
| Last Name Of The Provider | SIDDALL |
| First Name Of The Provider | KRISTINA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4755 OGLETOWN STANTON RD |
| Street Address 2 Of The Provider | DEPARTMENT OF RADIOLOGY |
| City Of The Provider | NEWARK |
| Zip Code Of The Provider | 197182200 |
| State Code Of The Provider | DE |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 109 |
| Number Of Services | 8106 |
| Number Of Medicare Beneficiaries | 5210 |
| Total Submitted Charge Amount | 340378.35 |
| Total Medicare Allowed Amount | 129177.82 |
| Total Medicare Payment Amount | 106488.28 |
| Total Medicare Standardized Payment Amount | 105208.95 |
| Drug Suppress Indicator | * |
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| Number Of Medicare Beneficiaries With Drug Services | |
| Total Drug Submitted ChargeAmount | |
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| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
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| Number Of Medicare Beneficiaries With Medical Services | |
| Total Medical Submitted Charge Amount | |
| Total Medical Medicare Allowed Amount | |
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| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 920 |
| Number Of Beneficiaries Age 65 to 74 | 2013 |
| Number Of Beneficiaries Age 75 to 84 | 1417 |
| Number Of Beneficiaries Age Greater 84 | 860 |
| Number Of Female Beneficiaries | 3381 |
| Number Of Male Beneficiaries | 1829 |
| Number Of Non Hispanic White Beneficiaries | 3847 |
| Number Of Black or African American Beneficiaries | 1083 |
| Number Of AsianPacific Islander Beneficiaries | 76 |
| Number Of Hispanic Beneficiaries | 143 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 3994 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1216 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.7986 |