| National Provider Identifier [NPI]: | 1285636647 |
| Last Name Of The Provider | VAZ |
| First Name Of The Provider | GARTH |
| Middle Initial Of The Provider | O |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1103 N SARAH DEWITT DR |
| Street Address 2 Of The Provider | 1103 N. SAHAH DEWITT DRIVE |
| City Of The Provider | GONZALES |
| Zip Code Of The Provider | 786293311 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 101 |
| Number Of Services | 6142 |
| Number Of Medicare Beneficiaries | 223 |
| Total Submitted Charge Amount | 312568.6 |
| Total Medicare Allowed Amount | 212810.35 |
| Total Medicare Payment Amount | 160458.84 |
| Total Medicare Standardized Payment Amount | 168861.16 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 24 |
| Number Of Drug Services | 1082 |
| Number Of Medicare Beneficiaries With Drug Services | 159 |
| Total Drug Submitted ChargeAmount | 22346.78 |
| Total Drug Medicare AllowedAmount | 9849.03 |
| Total Drug Medicare PaymentAmount | 8842.5 |
| Total Drug Medicare Standardized Payment Amount | 8842.5 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 77 |
| Number Of Medical Services | 5060 |
| Number Of Medicare Beneficiaries With Medical Services | 223 |
| Total Medical Submitted Charge Amount | 290221.82 |
| Total Medical Medicare Allowed Amount | 202961.32 |
| Total Medical Medicare Payment Amount | 151616.34 |
| Total Medical Medicare Standardized Payment Amount | 160018.66 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 61 |
| Number Of Beneficiaries Age 65 to 74 | 82 |
| Number Of Beneficiaries Age 75 to 84 | 57 |
| Number Of Beneficiaries Age Greater 84 | 23 |
| Number Of Female Beneficiaries | 126 |
| Number Of Male Beneficiaries | 97 |
| Number Of Non Hispanic White Beneficiaries | 135 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 50 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 136 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 87 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 5 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 29 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3968 |