| National Provider Identifier [NPI]: | 1336134733 |
| Last Name Of The Provider | RUDDOCK |
| First Name Of The Provider | TONIA |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4300 W MAIN ST |
| Street Address 2 Of The Provider | SUITE 102 |
| City Of The Provider | DOTHAN |
| Zip Code Of The Provider | 363051054 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 68 |
| Number Of Services | 8753 |
| Number Of Medicare Beneficiaries | 1921 |
| Total Submitted Charge Amount | 676861 |
| Total Medicare Allowed Amount | 463607.63 |
| Total Medicare Payment Amount | 318190.45 |
| Total Medicare Standardized Payment Amount | 352210.13 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 63 |
| Number Of Medicare Beneficiaries With Drug Services | 40 |
| Total Drug Submitted ChargeAmount | 16974 |
| Total Drug Medicare AllowedAmount | 13385.83 |
| Total Drug Medicare PaymentAmount | 9983.58 |
| Total Drug Medicare Standardized Payment Amount | 9983.58 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 66 |
| Number Of Medical Services | 8690 |
| Number Of Medicare Beneficiaries With Medical Services | 1921 |
| Total Medical Submitted Charge Amount | 659887 |
| Total Medical Medicare Allowed Amount | 450221.8 |
| Total Medical Medicare Payment Amount | 308206.87 |
| Total Medical Medicare Standardized Payment Amount | 342226.55 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 132 |
| Number Of Beneficiaries Age 65 to 74 | 990 |
| Number Of Beneficiaries Age 75 to 84 | 620 |
| Number Of Beneficiaries Age Greater 84 | 179 |
| Number Of Female Beneficiaries | 1018 |
| Number Of Male Beneficiaries | 903 |
| Number Of Non Hispanic White Beneficiaries | 1849 |
| Number Of Black or African American Beneficiaries | 47 |
| 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 | 13 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1764 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 157 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.891 |