| National Provider Identifier [NPI]: | 1649247545 |
| Last Name Of The Provider | BIDIKOV |
| First Name Of The Provider | IGOR |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 40 GILES ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | HEFLIN |
| Zip Code Of The Provider | 362641738 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 78 |
| Number Of Services | 9221 |
| Number Of Medicare Beneficiaries | 1559 |
| Total Submitted Charge Amount | 840070 |
| Total Medicare Allowed Amount | 617161.24 |
| Total Medicare Payment Amount | 451548.15 |
| Total Medicare Standardized Payment Amount | 489164.13 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 1699 |
| Number Of Medicare Beneficiaries With Drug Services | 368 |
| Total Drug Submitted ChargeAmount | 23405 |
| Total Drug Medicare AllowedAmount | 1724.3 |
| Total Drug Medicare PaymentAmount | 1451.44 |
| Total Drug Medicare Standardized Payment Amount | 1451.44 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 69 |
| Number Of Medical Services | 7522 |
| Number Of Medicare Beneficiaries With Medical Services | 1559 |
| Total Medical Submitted Charge Amount | 816665 |
| Total Medical Medicare Allowed Amount | 615436.94 |
| Total Medical Medicare Payment Amount | 450096.71 |
| Total Medical Medicare Standardized Payment Amount | 487712.69 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 325 |
| Number Of Beneficiaries Age 65 to 74 | 486 |
| Number Of Beneficiaries Age 75 to 84 | 451 |
| Number Of Beneficiaries Age Greater 84 | 297 |
| Number Of Female Beneficiaries | 975 |
| Number Of Male Beneficiaries | 584 |
| Number Of Non Hispanic White Beneficiaries | 1399 |
| Number Of Black or African American Beneficiaries | 145 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 996 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 563 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 41 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 58 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.6143 |