| National Provider Identifier [NPI]: | 1154349231 |
| Last Name Of The Provider | DODSON |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3250 GORDONVILLE RD |
| Street Address 2 Of The Provider | STE 301 |
| City Of The Provider | CAPE GIRARDEAU |
| Zip Code Of The Provider | 637035056 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 68 |
| Number Of Services | 2049 |
| Number Of Medicare Beneficiaries | 441 |
| Total Submitted Charge Amount | 450556 |
| Total Medicare Allowed Amount | 136607.16 |
| Total Medicare Payment Amount | 92863.51 |
| Total Medicare Standardized Payment Amount | 102213.53 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 18 |
| Number Of Drug Services | 453 |
| Number Of Medicare Beneficiaries With Drug Services | 215 |
| Total Drug Submitted ChargeAmount | 16917 |
| Total Drug Medicare AllowedAmount | 9438.07 |
| Total Drug Medicare PaymentAmount | 9012.25 |
| Total Drug Medicare Standardized Payment Amount | 9012.25 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 50 |
| Number Of Medical Services | 1596 |
| Number Of Medicare Beneficiaries With Medical Services | 441 |
| Total Medical Submitted Charge Amount | 433639 |
| Total Medical Medicare Allowed Amount | 127169.09 |
| Total Medical Medicare Payment Amount | 83851.26 |
| Total Medical Medicare Standardized Payment Amount | 93201.28 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 43 |
| Number Of Beneficiaries Age 65 to 74 | 198 |
| Number Of Beneficiaries Age 75 to 84 | 126 |
| Number Of Beneficiaries Age Greater 84 | 74 |
| Number Of Female Beneficiaries | 240 |
| Number Of Male Beneficiaries | 201 |
| Number Of Non Hispanic White Beneficiaries | 429 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 0 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 406 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 35 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9533 |