National Provider Identifier [NPI]: |
1497066724 |
Last Name Of The Provider |
SIDDIQUI |
First Name Of The Provider |
NADIA |
Middle Initial Of The Provider |
N |
Credentials Of The Provider |
M.D |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
14131 MIDWAY RD |
Street Address 2 Of The Provider |
SUITE 620 |
City Of The Provider |
ADDISON |
Zip Code Of The Provider |
750013623 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
11 |
Number Of Services |
2538 |
Number Of Medicare Beneficiaries |
546 |
Total Submitted Charge Amount |
505727 |
Total Medicare Allowed Amount |
254542.97 |
Total Medicare Payment Amount |
198806.29 |
Total Medicare Standardized Payment Amount |
201575 |
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 |
11 |
Number Of Medical Services |
2538 |
Number Of Medicare Beneficiaries With Medical Services |
546 |
Total Medical Submitted Charge Amount |
505727 |
Total Medical Medicare Allowed Amount |
254542.97 |
Total Medical Medicare Payment Amount |
198806.29 |
Total Medical Medicare Standardized Payment Amount |
201575 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
169 |
Number Of Beneficiaries Age 65 to 74 |
179 |
Number Of Beneficiaries Age 75 to 84 |
127 |
Number Of Beneficiaries Age Greater 84 |
71 |
Number Of Female Beneficiaries |
309 |
Number Of Male Beneficiaries |
237 |
Number Of Non Hispanic White Beneficiaries |
332 |
Number Of Black or African American Beneficiaries |
124 |
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 |
351 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
195 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
52 |
Percent Of With Chronic Kidney Disease |
67 |
Percent Of With Chronic Obstructive Pulmonary Disease |
37 |
Percent Of With Depression |
47 |
Percent Of With Diabetes |
58 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
60 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
3.5278 |