| National Provider Identifier [NPI]: | 1366427338 |
| Last Name Of The Provider | KIDD |
| First Name Of The Provider | DONALD |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 101 MEMORIAL HOSPITAL DR |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | MOBILE |
| Zip Code Of The Provider | 366081786 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 106 |
| Number Of Services | 5788 |
| Number Of Medicare Beneficiaries | 1082 |
| Total Submitted Charge Amount | 558262.84 |
| Total Medicare Allowed Amount | 321239.01 |
| Total Medicare Payment Amount | 235868.61 |
| Total Medicare Standardized Payment Amount | 251664.52 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 998 |
| Number Of Medicare Beneficiaries With Drug Services | 112 |
| Total Drug Submitted ChargeAmount | 159152.99 |
| Total Drug Medicare AllowedAmount | 79489.36 |
| Total Drug Medicare PaymentAmount | 59215.26 |
| Total Drug Medicare Standardized Payment Amount | 59215.26 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 93 |
| Number Of Medical Services | 4790 |
| Number Of Medicare Beneficiaries With Medical Services | 1082 |
| Total Medical Submitted Charge Amount | 399109.85 |
| Total Medical Medicare Allowed Amount | 241749.65 |
| Total Medical Medicare Payment Amount | 176653.35 |
| Total Medical Medicare Standardized Payment Amount | 192449.26 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 124 |
| Number Of Beneficiaries Age 65 to 74 | 459 |
| Number Of Beneficiaries Age 75 to 84 | 385 |
| Number Of Beneficiaries Age Greater 84 | 114 |
| Number Of Female Beneficiaries | 149 |
| Number Of Male Beneficiaries | 933 |
| Number Of Non Hispanic White Beneficiaries | 834 |
| Number Of Black or African American Beneficiaries | 232 |
| 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 | 980 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 102 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 23 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 10 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 3 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.2658 |