| National Provider Identifier [NPI]: | 1376575738 |
| Last Name Of The Provider | GODFREY |
| First Name Of The Provider | CRAIG |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 765 LIBERTY ST |
| Street Address 2 Of The Provider | SUITE # 301 |
| City Of The Provider | MEADVILLE |
| Zip Code Of The Provider | 163352566 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 38 |
| Number Of Services | 3551 |
| Number Of Medicare Beneficiaries | 1067 |
| Total Submitted Charge Amount | 340369.06 |
| Total Medicare Allowed Amount | 175827.9 |
| Total Medicare Payment Amount | 131316.87 |
| Total Medicare Standardized Payment Amount | 137490.38 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 133 |
| Number Of Medicare Beneficiaries With Drug Services | 77 |
| Total Drug Submitted ChargeAmount | 4205 |
| Total Drug Medicare AllowedAmount | 2652.78 |
| Total Drug Medicare PaymentAmount | 2538.78 |
| Total Drug Medicare Standardized Payment Amount | 2538.78 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 34 |
| Number Of Medical Services | 3418 |
| Number Of Medicare Beneficiaries With Medical Services | 1067 |
| Total Medical Submitted Charge Amount | 336164.06 |
| Total Medical Medicare Allowed Amount | 173175.12 |
| Total Medical Medicare Payment Amount | 128778.09 |
| Total Medical Medicare Standardized Payment Amount | 134951.6 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 178 |
| Number Of Beneficiaries Age 65 to 74 | 358 |
| Number Of Beneficiaries Age 75 to 84 | 301 |
| Number Of Beneficiaries Age Greater 84 | 230 |
| Number Of Female Beneficiaries | 632 |
| Number Of Male Beneficiaries | 435 |
| Number Of Non Hispanic White Beneficiaries | 1026 |
| Number Of Black or African American Beneficiaries | 21 |
| 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 | 744 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 323 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.3395 |