| National Provider Identifier [NPI]: | 1558306902 |
| Last Name Of The Provider | SIDANI |
| First Name Of The Provider | TARIK |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 224 W ERIE AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | HARRISON |
| Zip Code Of The Provider | 726013539 |
| State Code Of The Provider | AR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 166 |
| Number Of Services | 8820 |
| Number Of Medicare Beneficiaries | 1459 |
| Total Submitted Charge Amount | 2819537 |
| Total Medicare Allowed Amount | 787585.89 |
| Total Medicare Payment Amount | 579201.8 |
| Total Medicare Standardized Payment Amount | 651471.53 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 1779 |
| Number Of Medicare Beneficiaries With Drug Services | 806 |
| Total Drug Submitted ChargeAmount | 99600 |
| Total Drug Medicare AllowedAmount | 48399.33 |
| Total Drug Medicare PaymentAmount | 36446.64 |
| Total Drug Medicare Standardized Payment Amount | 36446.64 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 164 |
| Number Of Medical Services | 7041 |
| Number Of Medicare Beneficiaries With Medical Services | 1459 |
| Total Medical Submitted Charge Amount | 2719937 |
| Total Medical Medicare Allowed Amount | 739186.56 |
| Total Medical Medicare Payment Amount | 542755.16 |
| Total Medical Medicare Standardized Payment Amount | 615024.89 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 277 |
| Number Of Beneficiaries Age 65 to 74 | 578 |
| Number Of Beneficiaries Age 75 to 84 | 432 |
| Number Of Beneficiaries Age Greater 84 | 172 |
| Number Of Female Beneficiaries | 914 |
| Number Of Male Beneficiaries | 545 |
| Number Of Non Hispanic White Beneficiaries | 1425 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 14 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1100 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 359 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 71 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0782 |