| National Provider Identifier [NPI]: | 1073573788 |
| Last Name Of The Provider | SPENCE |
| First Name Of The Provider | TIMOTHY |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | O.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9550 JONES BRIDGE RD |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | ALPHARETTA |
| Zip Code Of The Provider | 30022 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Optometry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 24 |
| Number Of Services | 412 |
| Number Of Medicare Beneficiaries | 207 |
| Total Submitted Charge Amount | 49337 |
| Total Medicare Allowed Amount | 39774.37 |
| Total Medicare Payment Amount | 28822.25 |
| Total Medicare Standardized Payment Amount | 30250.02 |
| 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 | 24 |
| Number Of Medical Services | 412 |
| Number Of Medicare Beneficiaries With Medical Services | 207 |
| Total Medical Submitted Charge Amount | 49337 |
| Total Medical Medicare Allowed Amount | 39774.37 |
| Total Medical Medicare Payment Amount | 28822.25 |
| Total Medical Medicare Standardized Payment Amount | 30250.02 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 20 |
| Number Of Beneficiaries Age 65 to 74 | 81 |
| Number Of Beneficiaries Age 75 to 84 | 62 |
| Number Of Beneficiaries Age Greater 84 | 44 |
| Number Of Female Beneficiaries | 130 |
| Number Of Male Beneficiaries | 77 |
| Number Of Non Hispanic White Beneficiaries | 171 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 178 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 29 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.4349 |