| National Provider Identifier [NPI]: | 1801052659 |
| Last Name Of The Provider | SIDDIQUI |
| First Name Of The Provider | NADIA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3700 W 203RD ST |
| Street Address 2 Of The Provider | SUITE 301 |
| City Of The Provider | OLYMPIA FIELDS |
| Zip Code Of The Provider | 604611180 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 39 |
| Number Of Services | 445 |
| Number Of Medicare Beneficiaries | 135 |
| Total Submitted Charge Amount | 31125.97 |
| Total Medicare Allowed Amount | 24784.76 |
| Total Medicare Payment Amount | 16296.76 |
| Total Medicare Standardized Payment Amount | 15471.81 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 49 |
| Number Of Medicare Beneficiaries With Drug Services | 19 |
| Total Drug Submitted ChargeAmount | 447.68 |
| Total Drug Medicare AllowedAmount | 215.34 |
| Total Drug Medicare PaymentAmount | 187.58 |
| Total Drug Medicare Standardized Payment Amount | 187.58 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 396 |
| Number Of Medicare Beneficiaries With Medical Services | 135 |
| Total Medical Submitted Charge Amount | 30678.29 |
| Total Medical Medicare Allowed Amount | 24569.42 |
| Total Medical Medicare Payment Amount | 16109.18 |
| Total Medical Medicare Standardized Payment Amount | 15284.23 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 84 |
| Number Of Beneficiaries Age 75 to 84 | 27 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 77 |
| Number Of Male Beneficiaries | 58 |
| Number Of Non Hispanic White Beneficiaries | 120 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 10 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7818 |