| National Provider Identifier [NPI]: | 1336120757 |
| Last Name Of The Provider | SIEGEL |
| First Name Of The Provider | WILLIAM |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 110 LIBERTY STREET |
| Street Address 2 Of The Provider | |
| City Of The Provider | BROCKTON |
| Zip Code Of The Provider | 02301 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 74 |
| Number Of Services | 6156 |
| Number Of Medicare Beneficiaries | 2034 |
| Total Submitted Charge Amount | 820605 |
| Total Medicare Allowed Amount | 311067.29 |
| Total Medicare Payment Amount | 230117.48 |
| Total Medicare Standardized Payment Amount | 223658.75 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 289 |
| Number Of Medicare Beneficiaries With Drug Services | 79 |
| Total Drug Submitted ChargeAmount | 13880 |
| Total Drug Medicare AllowedAmount | 9238.67 |
| Total Drug Medicare PaymentAmount | 7306.05 |
| Total Drug Medicare Standardized Payment Amount | 7306.05 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 63 |
| Number Of Medical Services | 5867 |
| Number Of Medicare Beneficiaries With Medical Services | 2033 |
| Total Medical Submitted Charge Amount | 806725 |
| Total Medical Medicare Allowed Amount | 301828.62 |
| Total Medical Medicare Payment Amount | 222811.43 |
| Total Medical Medicare Standardized Payment Amount | 216352.7 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 569 |
| Number Of Beneficiaries Age 65 to 74 | 699 |
| Number Of Beneficiaries Age 75 to 84 | 484 |
| Number Of Beneficiaries Age Greater 84 | 282 |
| Number Of Female Beneficiaries | 1068 |
| Number Of Male Beneficiaries | 966 |
| Number Of Non Hispanic White Beneficiaries | 1665 |
| Number Of Black or African American Beneficiaries | 197 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 98 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 59 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1176 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 858 |
| Percent Of With Atrial Fibrillation | 24 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.8772 |