National Provider Identifier [NPI]: |
1477635027 |
Last Name Of The Provider |
SIDDIQUI |
First Name Of The Provider |
SAYYADUL |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
10100 KANIS RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
LITTLE ROCK |
Zip Code Of The Provider |
722056202 |
State Code Of The Provider |
AR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
84 |
Number Of Services |
3462 |
Number Of Medicare Beneficiaries |
1426 |
Total Submitted Charge Amount |
649917.49 |
Total Medicare Allowed Amount |
285329.44 |
Total Medicare Payment Amount |
210554.28 |
Total Medicare Standardized Payment Amount |
230917.33 |
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 |
84 |
Number Of Medical Services |
3462 |
Number Of Medicare Beneficiaries With Medical Services |
1426 |
Total Medical Submitted Charge Amount |
649917.49 |
Total Medical Medicare Allowed Amount |
285329.44 |
Total Medical Medicare Payment Amount |
210554.28 |
Total Medical Medicare Standardized Payment Amount |
230917.33 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
139 |
Number Of Beneficiaries Age 65 to 74 |
566 |
Number Of Beneficiaries Age 75 to 84 |
513 |
Number Of Beneficiaries Age Greater 84 |
208 |
Number Of Female Beneficiaries |
722 |
Number Of Male Beneficiaries |
704 |
Number Of Non Hispanic White Beneficiaries |
1251 |
Number Of Black or African American Beneficiaries |
153 |
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 |
11 |
Number Of Beneficiaries With Medicare Only Entitlement |
1230 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
196 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
37 |
Percent Of With Chronic Kidney Disease |
29 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
73 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.4657 |