| National Provider Identifier [NPI]: | 1528273026 |
| Last Name Of The Provider | CRAVEN |
| First Name Of The Provider | MOLLY |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 230 TEMPLE ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | MASON |
| Zip Code Of The Provider | 488541851 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 31 |
| Number Of Services | 205 |
| Number Of Medicare Beneficiaries | 86 |
| Total Submitted Charge Amount | 20381.35 |
| Total Medicare Allowed Amount | 15936.28 |
| Total Medicare Payment Amount | 10920.72 |
| Total Medicare Standardized Payment Amount | 11400.75 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 27 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 522 |
| Total Drug Medicare AllowedAmount | 326.84 |
| Total Drug Medicare PaymentAmount | 316.46 |
| Total Drug Medicare Standardized Payment Amount | 316.46 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 24 |
| Number Of Medical Services | 178 |
| Number Of Medicare Beneficiaries With Medical Services | 86 |
| Total Medical Submitted Charge Amount | 19859.35 |
| Total Medical Medicare Allowed Amount | 15609.44 |
| Total Medical Medicare Payment Amount | 10604.26 |
| Total Medical Medicare Standardized Payment Amount | 11084.29 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 15 |
| Number Of Beneficiaries Age 65 to 74 | 40 |
| Number Of Beneficiaries Age 75 to 84 | 19 |
| Number Of Beneficiaries Age Greater 84 | 12 |
| Number Of Female Beneficiaries | 59 |
| Number Of Male Beneficiaries | 27 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 73 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 13 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9822 |