National Provider Identifier [NPI]: |
1407142086 |
Last Name Of The Provider |
KIDD |
First Name Of The Provider |
AYESHA |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
O.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7930 MOFFETT RD |
Street Address 2 Of The Provider |
SUITE A AND B |
City Of The Provider |
SEMMES |
Zip Code Of The Provider |
365755490 |
State Code Of The Provider |
AL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Optometry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
804 |
Number Of Medicare Beneficiaries |
642 |
Total Submitted Charge Amount |
118282.11 |
Total Medicare Allowed Amount |
99292.62 |
Total Medicare Payment Amount |
77088.25 |
Total Medicare Standardized Payment Amount |
84375.65 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
13 |
Number Of Medical Services |
804 |
Number Of Medicare Beneficiaries With Medical Services |
642 |
Total Medical Submitted Charge Amount |
118282.11 |
Total Medical Medicare Allowed Amount |
99292.62 |
Total Medical Medicare Payment Amount |
77088.25 |
Total Medical Medicare Standardized Payment Amount |
84375.65 |
Average Age Of Beneficiaries |
79 |
Number Of Beneficiaries Age Less65 |
74 |
Number Of Beneficiaries Age 65 to 74 |
131 |
Number Of Beneficiaries Age 75 to 84 |
181 |
Number Of Beneficiaries Age Greater 84 |
256 |
Number Of Female Beneficiaries |
391 |
Number Of Male Beneficiaries |
251 |
Number Of Non Hispanic White Beneficiaries |
465 |
Number Of Black or African American Beneficiaries |
163 |
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 |
175 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
467 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
75 |
Percent Of With Asthma |
3 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
41 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
49 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
26 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
1.9886 |