| National Provider Identifier [NPI]: | 1881620003 |
| Last Name Of The Provider | DIXON |
| First Name Of The Provider | TYMWA |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4700 SHREVEPORT BLANCHARD HWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | SHREVEPORT |
| Zip Code Of The Provider | 711074702 |
| State Code Of The Provider | LA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 30 |
| Number Of Services | 1926 |
| Number Of Medicare Beneficiaries | 362 |
| Total Submitted Charge Amount | 197270.2 |
| Total Medicare Allowed Amount | 109891.68 |
| Total Medicare Payment Amount | 68179.88 |
| Total Medicare Standardized Payment Amount | 73937.02 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 262 |
| Number Of Medicare Beneficiaries With Drug Services | 86 |
| Total Drug Submitted ChargeAmount | 3183.2 |
| Total Drug Medicare AllowedAmount | 1305.88 |
| Total Drug Medicare PaymentAmount | 1227.55 |
| Total Drug Medicare Standardized Payment Amount | 1227.55 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 18 |
| Number Of Medical Services | 1664 |
| Number Of Medicare Beneficiaries With Medical Services | 361 |
| Total Medical Submitted Charge Amount | 194087 |
| Total Medical Medicare Allowed Amount | 108585.8 |
| Total Medical Medicare Payment Amount | 66952.33 |
| Total Medical Medicare Standardized Payment Amount | 72709.47 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 144 |
| Number Of Beneficiaries Age 65 to 74 | 126 |
| Number Of Beneficiaries Age 75 to 84 | 77 |
| Number Of Beneficiaries Age Greater 84 | 15 |
| Number Of Female Beneficiaries | 210 |
| Number Of Male Beneficiaries | 152 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | 328 |
| 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 | 93 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 269 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0889 |