| 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 |