| National Provider Identifier [NPI]: | 1407170103 |
| Last Name Of The Provider | DODSON |
| First Name Of The Provider | ERIN |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | D.P.M. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4370 KINGS WAY STE B |
| Street Address 2 Of The Provider | |
| City Of The Provider | VALDOSTA |
| Zip Code Of The Provider | 316026905 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 33 |
| Number Of Services | 558 |
| Number Of Medicare Beneficiaries | 305 |
| Total Submitted Charge Amount | 65329.37 |
| Total Medicare Allowed Amount | 26984.7 |
| Total Medicare Payment Amount | 17520.14 |
| Total Medicare Standardized Payment Amount | 18933.62 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 66 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 238 |
| Total Drug Medicare AllowedAmount | 30.53 |
| Total Drug Medicare PaymentAmount | 23.93 |
| Total Drug Medicare Standardized Payment Amount | 23.93 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 30 |
| Number Of Medical Services | 492 |
| Number Of Medicare Beneficiaries With Medical Services | 305 |
| Total Medical Submitted Charge Amount | 65091.37 |
| Total Medical Medicare Allowed Amount | 26954.17 |
| Total Medical Medicare Payment Amount | 17496.21 |
| Total Medical Medicare Standardized Payment Amount | 18909.69 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 60 |
| Number Of Beneficiaries Age 65 to 74 | 129 |
| Number Of Beneficiaries Age 75 to 84 | 77 |
| Number Of Beneficiaries Age Greater 84 | 39 |
| Number Of Female Beneficiaries | 176 |
| Number Of Male Beneficiaries | 129 |
| Number Of Non Hispanic White Beneficiaries | 202 |
| 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 | 205 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 100 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 70 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.6413 |