| National Provider Identifier [NPI]: | 1710915012 |
| Last Name Of The Provider | TILLMAN |
| First Name Of The Provider | TYWAUN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2700 CITIZENS PLZ |
| Street Address 2 Of The Provider | SUITE 300 |
| City Of The Provider | VICTORIA |
| Zip Code Of The Provider | 779015754 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 109 |
| Number Of Services | 3587 |
| Number Of Medicare Beneficiaries | 1524 |
| Total Submitted Charge Amount | 1093422.88 |
| Total Medicare Allowed Amount | 301483.35 |
| Total Medicare Payment Amount | 227973.11 |
| Total Medicare Standardized Payment Amount | 244996.13 |
| 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 | 109 |
| Number Of Medical Services | 3587 |
| Number Of Medicare Beneficiaries With Medical Services | 1524 |
| Total Medical Submitted Charge Amount | 1093422.88 |
| Total Medical Medicare Allowed Amount | 301483.35 |
| Total Medical Medicare Payment Amount | 227973.11 |
| Total Medical Medicare Standardized Payment Amount | 244996.13 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 190 |
| Number Of Beneficiaries Age 65 to 74 | 535 |
| Number Of Beneficiaries Age 75 to 84 | 534 |
| Number Of Beneficiaries Age Greater 84 | 265 |
| Number Of Female Beneficiaries | 785 |
| Number Of Male Beneficiaries | 739 |
| Number Of Non Hispanic White Beneficiaries | 1068 |
| Number Of Black or African American Beneficiaries | 103 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 333 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1157 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 367 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 60 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.6221 |