| National Provider Identifier [NPI]: | 1861444911 |
| Last Name Of The Provider | SIECKE |
| First Name Of The Provider | NEIL |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7320 216TH ST SW |
| Street Address 2 Of The Provider | STE. 210 |
| City Of The Provider | EDMONDS |
| Zip Code Of The Provider | 980268006 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 65 |
| Number Of Services | 3777 |
| Number Of Medicare Beneficiaries | 1062 |
| Total Submitted Charge Amount | 667600 |
| Total Medicare Allowed Amount | 218339.81 |
| Total Medicare Payment Amount | 159386.77 |
| Total Medicare Standardized Payment Amount | 164896.49 |
| 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 | 65 |
| Number Of Medical Services | 3777 |
| Number Of Medicare Beneficiaries With Medical Services | 1062 |
| Total Medical Submitted Charge Amount | 667600 |
| Total Medical Medicare Allowed Amount | 218339.81 |
| Total Medical Medicare Payment Amount | 159386.77 |
| Total Medical Medicare Standardized Payment Amount | 164896.49 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 88 |
| Number Of Beneficiaries Age 65 to 74 | 311 |
| Number Of Beneficiaries Age 75 to 84 | 394 |
| Number Of Beneficiaries Age Greater 84 | 269 |
| Number Of Female Beneficiaries | 567 |
| Number Of Male Beneficiaries | 495 |
| Number Of Non Hispanic White Beneficiaries | 931 |
| Number Of Black or African American Beneficiaries | 13 |
| Number Of AsianPacific Islander Beneficiaries | 64 |
| Number Of Hispanic Beneficiaries | 16 |
| Number Of American Indian Alaska Native Beneficiaries | 11 |
| Number Of Beneficiaries With Race Not Else where Classified | 27 |
| Number Of Beneficiaries With Medicare Only Entitlement | 849 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 213 |
| Percent Of With Atrial Fibrillation | 30 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.6229 |