| National Provider Identifier [NPI]: | 1134107360 |
| Last Name Of The Provider | GARBACZ |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1518 10TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | WICHITA FALLS |
| Zip Code Of The Provider | 763014405 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 64 |
| Number Of Services | 8246 |
| Number Of Medicare Beneficiaries | 1349 |
| Total Submitted Charge Amount | 1438422.36 |
| Total Medicare Allowed Amount | 644343.62 |
| Total Medicare Payment Amount | 472786.22 |
| Total Medicare Standardized Payment Amount | 489547.47 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 644 |
| Number Of Medicare Beneficiaries With Drug Services | 278 |
| Total Drug Submitted ChargeAmount | 140451 |
| Total Drug Medicare AllowedAmount | 106109.88 |
| Total Drug Medicare PaymentAmount | 82465.46 |
| Total Drug Medicare Standardized Payment Amount | 82465.46 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 61 |
| Number Of Medical Services | 7602 |
| Number Of Medicare Beneficiaries With Medical Services | 1349 |
| Total Medical Submitted Charge Amount | 1297971.36 |
| Total Medical Medicare Allowed Amount | 538233.74 |
| Total Medical Medicare Payment Amount | 390320.76 |
| Total Medical Medicare Standardized Payment Amount | 407082.01 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 88 |
| Number Of Beneficiaries Age 65 to 74 | 535 |
| Number Of Beneficiaries Age 75 to 84 | 546 |
| Number Of Beneficiaries Age Greater 84 | 180 |
| Number Of Female Beneficiaries | 595 |
| Number Of Male Beneficiaries | 754 |
| Number Of Non Hispanic White Beneficiaries | 1270 |
| Number Of Black or African American Beneficiaries | 26 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 32 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1257 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 92 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1283 |