| National Provider Identifier [NPI]: | 1659332542 |
| Last Name Of The Provider | SPENCER |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 14730 FRED AMITY RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | FREDERICKTOWN |
| Zip Code Of The Provider | 430199776 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 16 |
| Number Of Services | 1231 |
| Number Of Medicare Beneficiaries | 123 |
| Total Submitted Charge Amount | 99860 |
| Total Medicare Allowed Amount | 92592.9 |
| Total Medicare Payment Amount | 67480.96 |
| Total Medicare Standardized Payment Amount | 72578.65 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 78 |
| Number Of Medicare Beneficiaries With Drug Services | 55 |
| Total Drug Submitted ChargeAmount | 1950 |
| Total Drug Medicare AllowedAmount | 870.09 |
| Total Drug Medicare PaymentAmount | 841.92 |
| Total Drug Medicare Standardized Payment Amount | 841.92 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 14 |
| Number Of Medical Services | 1153 |
| Number Of Medicare Beneficiaries With Medical Services | 123 |
| Total Medical Submitted Charge Amount | 97910 |
| Total Medical Medicare Allowed Amount | 91722.81 |
| Total Medical Medicare Payment Amount | 66639.04 |
| Total Medical Medicare Standardized Payment Amount | 71736.73 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 38 |
| Number Of Beneficiaries Age 65 to 74 | 36 |
| Number Of Beneficiaries Age 75 to 84 | 31 |
| Number Of Beneficiaries Age Greater 84 | 18 |
| Number Of Female Beneficiaries | 60 |
| Number Of Male Beneficiaries | 63 |
| Number Of Non Hispanic White Beneficiaries | 123 |
| Number Of Black or African American Beneficiaries | 0 |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | 0 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 0 |
| Number Of Beneficiaries With Medicare Only Entitlement | 80 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 43 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 58 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 54 |
| Percent Of With Ischemic Heart Disease | 59 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.5442 |