| National Provider Identifier [NPI]: | 1043645526 |
| Last Name Of The Provider | SIDDIQUI |
| First Name Of The Provider | AJAZ |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 755 MEMORIAL PKWY |
| Street Address 2 Of The Provider | BLDG. 200 SUITE 201 |
| City Of The Provider | PHILLIPSBURG |
| Zip Code Of The Provider | 088652748 |
| State Code Of The Provider | NJ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Anesthesiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 68 |
| Number Of Services | 1260 |
| Number Of Medicare Beneficiaries | 184 |
| Total Submitted Charge Amount | 213375.2 |
| Total Medicare Allowed Amount | 130130.85 |
| Total Medicare Payment Amount | 101941.68 |
| Total Medicare Standardized Payment Amount | 94592.36 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 321 |
| Number Of Medicare Beneficiaries With Drug Services | 88 |
| Total Drug Submitted ChargeAmount | 10560 |
| Total Drug Medicare AllowedAmount | 1922.85 |
| Total Drug Medicare PaymentAmount | 1506.19 |
| Total Drug Medicare Standardized Payment Amount | 1506.19 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 60 |
| Number Of Medical Services | 939 |
| Number Of Medicare Beneficiaries With Medical Services | 184 |
| Total Medical Submitted Charge Amount | 202815.2 |
| Total Medical Medicare Allowed Amount | 128208 |
| Total Medical Medicare Payment Amount | 100435.49 |
| Total Medical Medicare Standardized Payment Amount | 93086.17 |
| Average Age Of Beneficiaries | 60 |
| Number Of Beneficiaries Age Less65 | 114 |
| Number Of Beneficiaries Age 65 to 74 | 45 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 91 |
| Number Of Male Beneficiaries | 93 |
| Number Of Non Hispanic White Beneficiaries | 151 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 16 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 105 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 79 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.1103 |