| National Provider Identifier [NPI]: | 1942260641 |
| Last Name Of The Provider | SIEGFELD |
| First Name Of The Provider | ALISA |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 40 HART ST |
| Street Address 2 Of The Provider | SUITE B1 |
| City Of The Provider | NEW BRITAIN |
| Zip Code Of The Provider | 060521743 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 123 |
| Number Of Services | 7448 |
| Number Of Medicare Beneficiaries | 1875 |
| Total Submitted Charge Amount | 751677 |
| Total Medicare Allowed Amount | 186531.54 |
| Total Medicare Payment Amount | 152467.46 |
| Total Medicare Standardized Payment Amount | 141922.12 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 4280 |
| Number Of Medicare Beneficiaries With Drug Services | 56 |
| Total Drug Submitted ChargeAmount | 3646 |
| Total Drug Medicare AllowedAmount | 1898.98 |
| Total Drug Medicare PaymentAmount | 1488.77 |
| Total Drug Medicare Standardized Payment Amount | 1488.77 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 120 |
| Number Of Medical Services | 3168 |
| Number Of Medicare Beneficiaries With Medical Services | 1875 |
| Total Medical Submitted Charge Amount | 748031 |
| Total Medical Medicare Allowed Amount | 184632.56 |
| Total Medical Medicare Payment Amount | 150978.69 |
| Total Medical Medicare Standardized Payment Amount | 140433.35 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 252 |
| Number Of Beneficiaries Age 65 to 74 | 761 |
| Number Of Beneficiaries Age 75 to 84 | 544 |
| Number Of Beneficiaries Age Greater 84 | 318 |
| Number Of Female Beneficiaries | 1460 |
| Number Of Male Beneficiaries | 415 |
| Number Of Non Hispanic White Beneficiaries | 1686 |
| Number Of Black or African American Beneficiaries | 59 |
| Number Of AsianPacific Islander Beneficiaries | 20 |
| Number Of Hispanic Beneficiaries | 88 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 22 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1358 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 517 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.2333 |