| National Provider Identifier [NPI]: | 1902860091 |
| Last Name Of The Provider | SIEGEL |
| First Name Of The Provider | STEPHEN |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | M. D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1579 STRAITS TPKE |
| Street Address 2 Of The Provider | SUITE 2A |
| City Of The Provider | MIDDLEBURY |
| Zip Code Of The Provider | 067621835 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 100 |
| Number Of Services | 13013 |
| Number Of Medicare Beneficiaries | 1004 |
| Total Submitted Charge Amount | 1011938.1 |
| Total Medicare Allowed Amount | 571087.37 |
| Total Medicare Payment Amount | 435188.13 |
| Total Medicare Standardized Payment Amount | 424721.05 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 17 |
| Number Of Drug Services | 8765 |
| Number Of Medicare Beneficiaries With Drug Services | 133 |
| Total Drug Submitted ChargeAmount | 470999.6 |
| Total Drug Medicare AllowedAmount | 316593.17 |
| Total Drug Medicare PaymentAmount | 247480.21 |
| Total Drug Medicare Standardized Payment Amount | 247480.21 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 83 |
| Number Of Medical Services | 4248 |
| Number Of Medicare Beneficiaries With Medical Services | 1004 |
| Total Medical Submitted Charge Amount | 540938.5 |
| Total Medical Medicare Allowed Amount | 254494.2 |
| Total Medical Medicare Payment Amount | 187707.92 |
| Total Medical Medicare Standardized Payment Amount | 177240.84 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 168 |
| Number Of Beneficiaries Age 65 to 74 | 349 |
| Number Of Beneficiaries Age 75 to 84 | 318 |
| Number Of Beneficiaries Age Greater 84 | 169 |
| Number Of Female Beneficiaries | 280 |
| Number Of Male Beneficiaries | 724 |
| Number Of Non Hispanic White Beneficiaries | 858 |
| Number Of Black or African American Beneficiaries | 54 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 72 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 671 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 333 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 22 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.4797 |