| National Provider Identifier [NPI]: | 1700825452 |
| Last Name Of The Provider | SIDARI |
| First Name Of The Provider | JUDE |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 235 W CHESTNUT ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | HAZLETON |
| Zip Code Of The Provider | 182016230 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 57 |
| Number Of Services | 13225 |
| Number Of Medicare Beneficiaries | 889 |
| Total Submitted Charge Amount | 880298 |
| Total Medicare Allowed Amount | 758902.07 |
| Total Medicare Payment Amount | 552266.45 |
| Total Medicare Standardized Payment Amount | 528386.48 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 1966 |
| Number Of Medicare Beneficiaries With Drug Services | 466 |
| Total Drug Submitted ChargeAmount | 20223 |
| Total Drug Medicare AllowedAmount | 14880.44 |
| Total Drug Medicare PaymentAmount | 13675.51 |
| Total Drug Medicare Standardized Payment Amount | 13675.51 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 48 |
| Number Of Medical Services | 11259 |
| Number Of Medicare Beneficiaries With Medical Services | 889 |
| Total Medical Submitted Charge Amount | 860075 |
| Total Medical Medicare Allowed Amount | 744021.63 |
| Total Medical Medicare Payment Amount | 538590.94 |
| Total Medical Medicare Standardized Payment Amount | 514710.97 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 156 |
| Number Of Beneficiaries Age 65 to 74 | 279 |
| Number Of Beneficiaries Age 75 to 84 | 259 |
| Number Of Beneficiaries Age Greater 84 | 195 |
| Number Of Female Beneficiaries | 516 |
| Number Of Male Beneficiaries | 373 |
| Number Of Non Hispanic White Beneficiaries | 844 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 25 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 610 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 279 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 40 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 71 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.5381 |