| National Provider Identifier [NPI]: | 1407992928 |
| Last Name Of The Provider | KIDIYOOR |
| First Name Of The Provider | SOUMYA |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | M.D |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2815 S SHERIDAN RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | TULSA |
| Zip Code Of The Provider | 741291013 |
| State Code Of The Provider | OK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 17 |
| Number Of Services | 1976 |
| Number Of Medicare Beneficiaries | 596 |
| Total Submitted Charge Amount | 251009.2 |
| Total Medicare Allowed Amount | 168840.97 |
| Total Medicare Payment Amount | 131541.69 |
| Total Medicare Standardized Payment Amount | 138922.92 |
| 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 | 17 |
| Number Of Medical Services | 1976 |
| Number Of Medicare Beneficiaries With Medical Services | 596 |
| Total Medical Submitted Charge Amount | 251009.2 |
| Total Medical Medicare Allowed Amount | 168840.97 |
| Total Medical Medicare Payment Amount | 131541.69 |
| Total Medical Medicare Standardized Payment Amount | 138922.92 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 161 |
| Number Of Beneficiaries Age 65 to 74 | 213 |
| Number Of Beneficiaries Age 75 to 84 | 155 |
| Number Of Beneficiaries Age Greater 84 | 67 |
| Number Of Female Beneficiaries | 329 |
| Number Of Male Beneficiaries | 267 |
| Number Of Non Hispanic White Beneficiaries | 382 |
| Number Of Black or African American Beneficiaries | 92 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 107 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 328 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 268 |
| Percent Of With Atrial Fibrillation | 26 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 57 |
| Percent Of With Chronic Kidney Disease | 60 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 50 |
| Percent Of With Depression | 45 |
| Percent Of With Diabetes | 52 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 69 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.498 |