| National Provider Identifier [NPI]: | 1881657245 |
| Last Name Of The Provider | MATTISON |
| First Name Of The Provider | TANNER |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6221 RIVERSIDE DR |
| Street Address 2 Of The Provider | SUITE 119 |
| City Of The Provider | IRVING |
| Zip Code Of The Provider | 750393541 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 56 |
| Number Of Services | 33350 |
| Number Of Medicare Beneficiaries | 14228 |
| Total Submitted Charge Amount | 7629871.26 |
| Total Medicare Allowed Amount | 3793036.35 |
| Total Medicare Payment Amount | 2981889.16 |
| Total Medicare Standardized Payment Amount | 2840966.14 |
| 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 | 56 |
| Number Of Medical Services | 33350 |
| Number Of Medicare Beneficiaries With Medical Services | 14228 |
| Total Medical Submitted Charge Amount | 7629871.26 |
| Total Medical Medicare Allowed Amount | 3793036.35 |
| Total Medical Medicare Payment Amount | 2981889.16 |
| Total Medical Medicare Standardized Payment Amount | 2840966.14 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 1320 |
| Number Of Beneficiaries Age 65 to 74 | 6678 |
| Number Of Beneficiaries Age 75 to 84 | 4696 |
| Number Of Beneficiaries Age Greater 84 | 1534 |
| Number Of Female Beneficiaries | 4224 |
| Number Of Male Beneficiaries | 10004 |
| Number Of Non Hispanic White Beneficiaries | 11440 |
| Number Of Black or African American Beneficiaries | 1547 |
| Number Of AsianPacific Islander Beneficiaries | 82 |
| Number Of Hispanic Beneficiaries | 927 |
| Number Of American Indian Alaska Native Beneficiaries | 63 |
| Number Of Beneficiaries With Race Not Else where Classified | 169 |
| Number Of Beneficiaries With Medicare Only Entitlement | 12435 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1793 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 26 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1497 |