| National Provider Identifier [NPI]: | 1275564189 |
| Last Name Of The Provider | SIDDOWAY |
| First Name Of The Provider | PAUL |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M D |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 300 W MERCURY ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | BUTTE |
| Zip Code Of The Provider | 597011652 |
| State Code Of The Provider | MT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 67 |
| Number Of Services | 4960 |
| Number Of Medicare Beneficiaries | 1279 |
| Total Submitted Charge Amount | 479371.13 |
| Total Medicare Allowed Amount | 142637.03 |
| Total Medicare Payment Amount | 108264.46 |
| Total Medicare Standardized Payment Amount | 109021.13 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 54 |
| Number Of Medicare Beneficiaries With Drug Services | 54 |
| Total Drug Submitted ChargeAmount | 1274.5 |
| Total Drug Medicare AllowedAmount | 1115.82 |
| Total Drug Medicare PaymentAmount | 1093.23 |
| Total Drug Medicare Standardized Payment Amount | 1093.23 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 63 |
| Number Of Medical Services | 4906 |
| Number Of Medicare Beneficiaries With Medical Services | 1279 |
| Total Medical Submitted Charge Amount | 478096.63 |
| Total Medical Medicare Allowed Amount | 141521.21 |
| Total Medical Medicare Payment Amount | 107171.23 |
| Total Medical Medicare Standardized Payment Amount | 107927.9 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 196 |
| Number Of Beneficiaries Age 65 to 74 | 498 |
| Number Of Beneficiaries Age 75 to 84 | 375 |
| Number Of Beneficiaries Age Greater 84 | 210 |
| Number Of Female Beneficiaries | 644 |
| Number Of Male Beneficiaries | 635 |
| Number Of Non Hispanic White Beneficiaries | 1224 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 28 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1018 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 261 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 37 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.3675 |