| National Provider Identifier [NPI]: | 1982915195 |
| Last Name Of The Provider | MIXON |
| First Name Of The Provider | TARISHA |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3401 NORTH BLVD |
| Street Address 2 Of The Provider | STE 200-A |
| City Of The Provider | BATON ROUGE |
| Zip Code Of The Provider | 708063743 |
| 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 | 34 |
| Number Of Services | 901 |
| Number Of Medicare Beneficiaries | 227 |
| Total Submitted Charge Amount | 81298 |
| Total Medicare Allowed Amount | 50084.58 |
| Total Medicare Payment Amount | 31650.86 |
| Total Medicare Standardized Payment Amount | 34313.4 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 213 |
| Number Of Medicare Beneficiaries With Drug Services | 72 |
| Total Drug Submitted ChargeAmount | 2682 |
| Total Drug Medicare AllowedAmount | 1025.62 |
| Total Drug Medicare PaymentAmount | 896.82 |
| Total Drug Medicare Standardized Payment Amount | 896.82 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 22 |
| Number Of Medical Services | 688 |
| Number Of Medicare Beneficiaries With Medical Services | 227 |
| Total Medical Submitted Charge Amount | 78616 |
| Total Medical Medicare Allowed Amount | 49058.96 |
| Total Medical Medicare Payment Amount | 30754.04 |
| Total Medical Medicare Standardized Payment Amount | 33416.58 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 77 |
| Number Of Beneficiaries Age 65 to 74 | 79 |
| Number Of Beneficiaries Age 75 to 84 | 43 |
| Number Of Beneficiaries Age Greater 84 | 28 |
| Number Of Female Beneficiaries | 142 |
| Number Of Male Beneficiaries | 85 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | 120 |
| 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 | 115 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 112 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 18 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.2549 |