| National Provider Identifier [NPI]: | 1346289501 |
| Last Name Of The Provider | SIDDIQI |
| First Name Of The Provider | ISRAR |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2746 OLD US 20 W STE C |
| Street Address 2 Of The Provider | |
| City Of The Provider | ELKHART |
| Zip Code Of The Provider | 465141365 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 76 |
| Number Of Services | 4729 |
| Number Of Medicare Beneficiaries | 865 |
| Total Submitted Charge Amount | 466618 |
| Total Medicare Allowed Amount | 286470.28 |
| Total Medicare Payment Amount | 208164.74 |
| Total Medicare Standardized Payment Amount | 215185.62 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 215 |
| Number Of Medicare Beneficiaries With Drug Services | 71 |
| Total Drug Submitted ChargeAmount | 6195 |
| Total Drug Medicare AllowedAmount | 3522.31 |
| Total Drug Medicare PaymentAmount | 3016.7 |
| Total Drug Medicare Standardized Payment Amount | 3016.7 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 65 |
| Number Of Medical Services | 4514 |
| Number Of Medicare Beneficiaries With Medical Services | 865 |
| Total Medical Submitted Charge Amount | 460423 |
| Total Medical Medicare Allowed Amount | 282947.97 |
| Total Medical Medicare Payment Amount | 205148.04 |
| Total Medical Medicare Standardized Payment Amount | 212168.92 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 209 |
| Number Of Beneficiaries Age 65 to 74 | 231 |
| Number Of Beneficiaries Age 75 to 84 | 247 |
| Number Of Beneficiaries Age Greater 84 | 178 |
| Number Of Female Beneficiaries | 507 |
| Number Of Male Beneficiaries | 358 |
| Number Of Non Hispanic White Beneficiaries | 768 |
| Number Of Black or African American Beneficiaries | 70 |
| 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 | 385 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 480 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 43 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 41 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 21 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 1.8542 |