| National Provider Identifier [NPI]: | 1144339904 |
| Last Name Of The Provider | DIXON |
| First Name Of The Provider | TYLER |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1477 N 2000 W |
| Street Address 2 Of The Provider | SUITE C |
| City Of The Provider | CLINTON |
| Zip Code Of The Provider | 840159099 |
| State Code Of The Provider | UT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 82 |
| Number Of Services | 1105 |
| Number Of Medicare Beneficiaries | 238 |
| Total Submitted Charge Amount | 61896.73 |
| Total Medicare Allowed Amount | 46882.21 |
| Total Medicare Payment Amount | 31309.6 |
| Total Medicare Standardized Payment Amount | 35160.46 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 20 |
| Number Of Drug Services | 274 |
| Number Of Medicare Beneficiaries With Drug Services | 86 |
| Total Drug Submitted ChargeAmount | 5281.95 |
| Total Drug Medicare AllowedAmount | 2720.55 |
| Total Drug Medicare PaymentAmount | 2281.32 |
| Total Drug Medicare Standardized Payment Amount | 2281.32 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 62 |
| Number Of Medical Services | 831 |
| Number Of Medicare Beneficiaries With Medical Services | 236 |
| Total Medical Submitted Charge Amount | 56614.78 |
| Total Medical Medicare Allowed Amount | 44161.66 |
| Total Medical Medicare Payment Amount | 29028.28 |
| Total Medical Medicare Standardized Payment Amount | 32879.14 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 43 |
| Number Of Beneficiaries Age 65 to 74 | 118 |
| Number Of Beneficiaries Age 75 to 84 | 55 |
| Number Of Beneficiaries Age Greater 84 | 22 |
| Number Of Female Beneficiaries | 132 |
| Number Of Male Beneficiaries | 106 |
| Number Of Non Hispanic White Beneficiaries | 209 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 14 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 212 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 26 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 36 |
| Percent Of With Hypertension | 50 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.901 |