| National Provider Identifier [NPI]: | 1538196860 |
| Last Name Of The Provider | SPOONER |
| First Name Of The Provider | STACY |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 800 HOWARD AVE |
| Street Address 2 Of The Provider | YALE PHYSICIANS BLDG |
| City Of The Provider | NEW HAVEN |
| Zip Code Of The Provider | 065191369 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 152 |
| Number Of Services | 4709 |
| Number Of Medicare Beneficiaries | 2797 |
| Total Submitted Charge Amount | 718872 |
| Total Medicare Allowed Amount | 149366.59 |
| Total Medicare Payment Amount | 115069.06 |
| Total Medicare Standardized Payment Amount | 109902.19 |
| 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 | 152 |
| Number Of Medical Services | 4709 |
| Number Of Medicare Beneficiaries With Medical Services | 2797 |
| Total Medical Submitted Charge Amount | 718872 |
| Total Medical Medicare Allowed Amount | 149366.59 |
| Total Medical Medicare Payment Amount | 115069.06 |
| Total Medical Medicare Standardized Payment Amount | 109902.19 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 635 |
| Number Of Beneficiaries Age 65 to 74 | 1034 |
| Number Of Beneficiaries Age 75 to 84 | 751 |
| Number Of Beneficiaries Age Greater 84 | 377 |
| Number Of Female Beneficiaries | 1953 |
| Number Of Male Beneficiaries | 844 |
| Number Of Non Hispanic White Beneficiaries | 2507 |
| Number Of Black or African American Beneficiaries | 97 |
| Number Of AsianPacific Islander Beneficiaries | 45 |
| Number Of Hispanic Beneficiaries | 77 |
| Number Of American Indian Alaska Native Beneficiaries | 16 |
| Number Of Beneficiaries With Race Not Else where Classified | 55 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1715 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1082 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.5827 |