| National Provider Identifier [NPI]: | 1568407179 |
| Last Name Of The Provider | SPICER |
| First Name Of The Provider | DARCY |
| Middle Initial Of The Provider | V |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1441 EASTLAKE AVE |
| Street Address 2 Of The Provider | NOR 8302E |
| City Of The Provider | LOS ANGELES |
| Zip Code Of The Provider | 900890112 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 11 |
| Number Of Services | 409 |
| Number Of Medicare Beneficiaries | 172 |
| Total Submitted Charge Amount | 98060 |
| Total Medicare Allowed Amount | 34001.65 |
| Total Medicare Payment Amount | 25164.35 |
| Total Medicare Standardized Payment Amount | 23666.4 |
| 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 | 11 |
| Number Of Medical Services | 409 |
| Number Of Medicare Beneficiaries With Medical Services | 172 |
| Total Medical Submitted Charge Amount | 98060 |
| Total Medical Medicare Allowed Amount | 34001.65 |
| Total Medical Medicare Payment Amount | 25164.35 |
| Total Medical Medicare Standardized Payment Amount | 23666.4 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 12 |
| Number Of Beneficiaries Age 65 to 74 | 71 |
| Number Of Beneficiaries Age 75 to 84 | 69 |
| Number Of Beneficiaries Age Greater 84 | 20 |
| Number Of Female Beneficiaries | 151 |
| Number Of Male Beneficiaries | 21 |
| Number Of Non Hispanic White Beneficiaries | 109 |
| Number Of Black or African American Beneficiaries | 16 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 27 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 147 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 25 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 71 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 37 |
| Percent Of With Hypertension | 59 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.539 |