| National Provider Identifier [NPI]: | 1972584910 |
| Last Name Of The Provider | SIDDIQI |
| First Name Of The Provider | NASIR |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 201 DUNN RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | FLORISSANT |
| Zip Code Of The Provider | 630317928 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Interventional Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 94 |
| Number Of Services | 62117 |
| Number Of Medicare Beneficiaries | 433 |
| Total Submitted Charge Amount | 6699482 |
| Total Medicare Allowed Amount | 2254668.86 |
| Total Medicare Payment Amount | 1748485.71 |
| Total Medicare Standardized Payment Amount | 1825003.08 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 58796 |
| Number Of Medicare Beneficiaries With Drug Services | 363 |
| Total Drug Submitted ChargeAmount | 76447 |
| Total Drug Medicare AllowedAmount | 22369.2 |
| Total Drug Medicare PaymentAmount | 17526.48 |
| Total Drug Medicare Standardized Payment Amount | 17526.48 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 92 |
| Number Of Medical Services | 3321 |
| Number Of Medicare Beneficiaries With Medical Services | 433 |
| Total Medical Submitted Charge Amount | 6623035 |
| Total Medical Medicare Allowed Amount | 2232299.66 |
| Total Medical Medicare Payment Amount | 1730959.23 |
| Total Medical Medicare Standardized Payment Amount | 1807476.6 |
| Average Age Of Beneficiaries | 64 |
| Number Of Beneficiaries Age Less65 | 202 |
| Number Of Beneficiaries Age 65 to 74 | 135 |
| Number Of Beneficiaries Age 75 to 84 | 65 |
| Number Of Beneficiaries Age Greater 84 | 31 |
| Number Of Female Beneficiaries | 217 |
| Number Of Male Beneficiaries | 216 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | 288 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 185 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 248 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 73 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 75 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 70 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 8.3635 |