| National Provider Identifier [NPI]: | 1407895709 |
| Last Name Of The Provider | ROARK |
| First Name Of The Provider | TOM |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3807 SPICEWOOD SPRINGS RD |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | AUSTIN |
| Zip Code Of The Provider | 787598965 |
| 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 | 20 |
| Number Of Services | 4743 |
| Number Of Medicare Beneficiaries | 645 |
| Total Submitted Charge Amount | 388586 |
| Total Medicare Allowed Amount | 208058.66 |
| Total Medicare Payment Amount | 147053.23 |
| Total Medicare Standardized Payment Amount | 146472.67 |
| 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 | 20 |
| Number Of Medical Services | 4743 |
| Number Of Medicare Beneficiaries With Medical Services | 645 |
| Total Medical Submitted Charge Amount | 388586 |
| Total Medical Medicare Allowed Amount | 208058.66 |
| Total Medical Medicare Payment Amount | 147053.23 |
| Total Medical Medicare Standardized Payment Amount | 146472.67 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 35 |
| Number Of Beneficiaries Age 65 to 74 | 349 |
| Number Of Beneficiaries Age 75 to 84 | 172 |
| Number Of Beneficiaries Age Greater 84 | 89 |
| Number Of Female Beneficiaries | 271 |
| Number Of Male Beneficiaries | 374 |
| Number Of Non Hispanic White Beneficiaries | 578 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 26 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 16 |
| Number Of Beneficiaries With Medicare Only Entitlement | 599 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 46 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 19 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 51 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9652 |