| National Provider Identifier [NPI]: | 1891764643 |
| Last Name Of The Provider | CRADDOCK |
| First Name Of The Provider | RUTH |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1801 WINDSOR RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | CHAMPAIGN |
| Zip Code Of The Provider | 618226217 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Rheumatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 22 |
| Number Of Services | 1003 |
| Number Of Medicare Beneficiaries | 324 |
| Total Submitted Charge Amount | 119088 |
| Total Medicare Allowed Amount | 74708.24 |
| Total Medicare Payment Amount | 51815.91 |
| Total Medicare Standardized Payment Amount | 53933.08 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 96 |
| Number Of Medicare Beneficiaries With Drug Services | 33 |
| Total Drug Submitted ChargeAmount | 1493 |
| Total Drug Medicare AllowedAmount | 204.86 |
| Total Drug Medicare PaymentAmount | 149.39 |
| Total Drug Medicare Standardized Payment Amount | 149.39 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 19 |
| Number Of Medical Services | 907 |
| Number Of Medicare Beneficiaries With Medical Services | 324 |
| Total Medical Submitted Charge Amount | 117595 |
| Total Medical Medicare Allowed Amount | 74503.38 |
| Total Medical Medicare Payment Amount | 51666.52 |
| Total Medical Medicare Standardized Payment Amount | 53783.69 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 37 |
| Number Of Beneficiaries Age 65 to 74 | 159 |
| Number Of Beneficiaries Age 75 to 84 | 107 |
| Number Of Beneficiaries Age Greater 84 | 21 |
| Number Of Female Beneficiaries | 243 |
| Number Of Male Beneficiaries | 81 |
| Number Of Non Hispanic White Beneficiaries | 305 |
| Number Of Black or African American Beneficiaries | |
| 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 | 287 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 37 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 3 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 18 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1498 |