| National Provider Identifier [NPI]: | 1699740217 |
| Last Name Of The Provider | SIEDHOF |
| First Name Of The Provider | ANGELA |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | CRNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 145 SHAFFER ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | SOUTH WILLIAMSPORT |
| Zip Code Of The Provider | 177026727 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 45 |
| Number Of Services | 967 |
| Number Of Medicare Beneficiaries | 166 |
| Total Submitted Charge Amount | 92842 |
| Total Medicare Allowed Amount | 37488.92 |
| Total Medicare Payment Amount | 25074.48 |
| Total Medicare Standardized Payment Amount | 31531.26 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 122 |
| Number Of Medicare Beneficiaries With Drug Services | 61 |
| Total Drug Submitted ChargeAmount | 3016 |
| Total Drug Medicare AllowedAmount | 1792.79 |
| Total Drug Medicare PaymentAmount | 1713 |
| Total Drug Medicare Standardized Payment Amount | 1713 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 34 |
| Number Of Medical Services | 845 |
| Number Of Medicare Beneficiaries With Medical Services | 166 |
| Total Medical Submitted Charge Amount | 89826 |
| Total Medical Medicare Allowed Amount | 35696.13 |
| Total Medical Medicare Payment Amount | 23361.48 |
| Total Medical Medicare Standardized Payment Amount | 29818.26 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 41 |
| Number Of Beneficiaries Age 65 to 74 | 78 |
| Number Of Beneficiaries Age 75 to 84 | 34 |
| Number Of Beneficiaries Age Greater 84 | 13 |
| Number Of Female Beneficiaries | 108 |
| Number Of Male Beneficiaries | 58 |
| 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 | 114 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 52 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 7 |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 30 |
| Percent Of With Hypertension | 41 |
| Percent Of With Ischemic Heart Disease | 19 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 20 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.901 |