| National Provider Identifier [NPI]: | 1205832854 |
| Last Name Of The Provider | HAIRSTON |
| First Name Of The Provider | EARLIE |
| Middle Initial Of The Provider | O |
| Credentials Of The Provider | D.P.M. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2919 COMMERCIAL WAY |
| Street Address 2 Of The Provider | |
| City Of The Provider | SPRING HILL |
| Zip Code Of The Provider | 346063319 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 32 |
| Number Of Services | 4900 |
| Number Of Medicare Beneficiaries | 1063 |
| Total Submitted Charge Amount | 358879.53 |
| Total Medicare Allowed Amount | 247640.32 |
| Total Medicare Payment Amount | 191289.9 |
| Total Medicare Standardized Payment Amount | 192563.73 |
| 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 | 32 |
| Number Of Medical Services | 4900 |
| Number Of Medicare Beneficiaries With Medical Services | 1063 |
| Total Medical Submitted Charge Amount | 358879.53 |
| Total Medical Medicare Allowed Amount | 247640.32 |
| Total Medical Medicare Payment Amount | 191289.9 |
| Total Medical Medicare Standardized Payment Amount | 192563.73 |
| Average Age Of Beneficiaries | 82 |
| Number Of Beneficiaries Age Less65 | 57 |
| Number Of Beneficiaries Age 65 to 74 | 182 |
| Number Of Beneficiaries Age 75 to 84 | 325 |
| Number Of Beneficiaries Age Greater 84 | 499 |
| Number Of Female Beneficiaries | 727 |
| Number Of Male Beneficiaries | 336 |
| Number Of Non Hispanic White Beneficiaries | 923 |
| Number Of Black or African American Beneficiaries | 93 |
| 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 | 622 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 441 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 64 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 52 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 57 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 61 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 20 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 2.1384 |