| National Provider Identifier [NPI]: | 1144293499 |
| Last Name Of The Provider | SIEGEL |
| First Name Of The Provider | ANDREW |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 255 W. SPRING VALLEY AVE |
| Street Address 2 Of The Provider | SUITE 101 |
| City Of The Provider | MAYWOOD |
| Zip Code Of The Provider | 07607 |
| State Code Of The Provider | NJ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 95 |
| Number Of Services | 8662 |
| Number Of Medicare Beneficiaries | 1225 |
| Total Submitted Charge Amount | 1792980 |
| Total Medicare Allowed Amount | 541730.51 |
| Total Medicare Payment Amount | 411441.79 |
| Total Medicare Standardized Payment Amount | 373432.01 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 1856 |
| Number Of Medicare Beneficiaries With Drug Services | 95 |
| Total Drug Submitted ChargeAmount | 161410 |
| Total Drug Medicare AllowedAmount | 48518.9 |
| Total Drug Medicare PaymentAmount | 37934.92 |
| Total Drug Medicare Standardized Payment Amount | 37934.92 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 87 |
| Number Of Medical Services | 6806 |
| Number Of Medicare Beneficiaries With Medical Services | 1225 |
| Total Medical Submitted Charge Amount | 1631570 |
| Total Medical Medicare Allowed Amount | 493211.61 |
| Total Medical Medicare Payment Amount | 373506.87 |
| Total Medical Medicare Standardized Payment Amount | 335497.09 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 34 |
| Number Of Beneficiaries Age 65 to 74 | 489 |
| Number Of Beneficiaries Age 75 to 84 | 489 |
| Number Of Beneficiaries Age Greater 84 | 213 |
| Number Of Female Beneficiaries | 341 |
| Number Of Male Beneficiaries | 884 |
| Number Of Non Hispanic White Beneficiaries | 1123 |
| Number Of Black or African American Beneficiaries | 26 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 43 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 20 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1194 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 31 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 23 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1374 |