| National Provider Identifier [NPI]: | 1538113659 |
| Last Name Of The Provider | SIDDOWAY |
| First Name Of The Provider | LYLE |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 25 MONUMENT RD |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | YORK |
| Zip Code Of The Provider | 174035060 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 88 |
| Number Of Services | 6852 |
| Number Of Medicare Beneficiaries | 2667 |
| Total Submitted Charge Amount | 1240888 |
| Total Medicare Allowed Amount | 475945.25 |
| Total Medicare Payment Amount | 353046.84 |
| Total Medicare Standardized Payment Amount | 367028.1 |
| 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 | 88 |
| Number Of Medical Services | 6852 |
| Number Of Medicare Beneficiaries With Medical Services | 2667 |
| Total Medical Submitted Charge Amount | 1240888 |
| Total Medical Medicare Allowed Amount | 475945.25 |
| Total Medical Medicare Payment Amount | 353046.84 |
| Total Medical Medicare Standardized Payment Amount | 367028.1 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 185 |
| Number Of Beneficiaries Age 65 to 74 | 728 |
| Number Of Beneficiaries Age 75 to 84 | 1025 |
| Number Of Beneficiaries Age Greater 84 | 729 |
| Number Of Female Beneficiaries | 1183 |
| Number Of Male Beneficiaries | 1484 |
| Number Of Non Hispanic White Beneficiaries | 2525 |
| Number Of Black or African American Beneficiaries | 71 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 32 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2404 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 263 |
| Percent Of With Atrial Fibrillation | 46 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 52 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 65 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.773 |