| National Provider Identifier [NPI]: | 1578651782 |
| Last Name Of The Provider | ERWIN |
| First Name Of The Provider | DALE |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1250 JESSE JEWELL PKWY SE STE 500 |
| Street Address 2 Of The Provider | |
| City Of The Provider | GAINESVILLE |
| Zip Code Of The Provider | 305013865 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 191 |
| Number Of Services | 11757 |
| Number Of Medicare Beneficiaries | 5015 |
| Total Submitted Charge Amount | 1254708 |
| Total Medicare Allowed Amount | 305605.1 |
| Total Medicare Payment Amount | 233298.52 |
| Total Medicare Standardized Payment Amount | 242732.83 |
| 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 | 191 |
| Number Of Medical Services | 11757 |
| Number Of Medicare Beneficiaries With Medical Services | 5015 |
| Total Medical Submitted Charge Amount | 1254708 |
| Total Medical Medicare Allowed Amount | 305605.1 |
| Total Medical Medicare Payment Amount | 233298.52 |
| Total Medical Medicare Standardized Payment Amount | 242732.83 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 528 |
| Number Of Beneficiaries Age 65 to 74 | 2349 |
| Number Of Beneficiaries Age 75 to 84 | 1513 |
| Number Of Beneficiaries Age Greater 84 | 625 |
| Number Of Female Beneficiaries | 3173 |
| Number Of Male Beneficiaries | 1842 |
| Number Of Non Hispanic White Beneficiaries | 4906 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 25 |
| Number Of American Indian Alaska Native Beneficiaries | 23 |
| Number Of Beneficiaries With Race Not Else where Classified | 45 |
| Number Of Beneficiaries With Medicare Only Entitlement | 4135 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 880 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1314 |