| National Provider Identifier [NPI]: | 1184684219 |
| Last Name Of The Provider | DIDDIE |
| First Name Of The Provider | KENNETH |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1220 LA VENTA DR |
| Street Address 2 Of The Provider | SUITE 211 |
| City Of The Provider | WESTLAKE VILLAGE |
| Zip Code Of The Provider | 913613703 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 27 |
| Number Of Services | 8748 |
| Number Of Medicare Beneficiaries | 1261 |
| Total Submitted Charge Amount | 1606289.16 |
| Total Medicare Allowed Amount | 799784.99 |
| Total Medicare Payment Amount | 597420.91 |
| Total Medicare Standardized Payment Amount | 555930.69 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 912 |
| Number Of Medicare Beneficiaries With Drug Services | 214 |
| Total Drug Submitted ChargeAmount | 138795 |
| Total Drug Medicare AllowedAmount | 86415.96 |
| Total Drug Medicare PaymentAmount | 65232.78 |
| Total Drug Medicare Standardized Payment Amount | 65232.78 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 22 |
| Number Of Medical Services | 7836 |
| Number Of Medicare Beneficiaries With Medical Services | 1261 |
| Total Medical Submitted Charge Amount | 1467494.16 |
| Total Medical Medicare Allowed Amount | 713369.03 |
| Total Medical Medicare Payment Amount | 532188.13 |
| Total Medical Medicare Standardized Payment Amount | 490697.91 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 33 |
| Number Of Beneficiaries Age 65 to 74 | 435 |
| Number Of Beneficiaries Age 75 to 84 | 432 |
| Number Of Beneficiaries Age Greater 84 | 361 |
| Number Of Female Beneficiaries | 731 |
| Number Of Male Beneficiaries | 530 |
| Number Of Non Hispanic White Beneficiaries | 1110 |
| Number Of Black or African American Beneficiaries | 16 |
| Number Of AsianPacific Islander Beneficiaries | 47 |
| Number Of Hispanic Beneficiaries | 57 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 31 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1159 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 102 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3141 |