National Provider Identifier [NPI]: |
1952343857 |
Last Name Of The Provider |
SPENCER |
First Name Of The Provider |
TODD |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7777 FOREST LN |
Street Address 2 Of The Provider |
SUITE C516 |
City Of The Provider |
DALLAS |
Zip Code Of The Provider |
752302571 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Vascular Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
110 |
Number Of Services |
5292 |
Number Of Medicare Beneficiaries |
560 |
Total Submitted Charge Amount |
5453566.91 |
Total Medicare Allowed Amount |
1017988.14 |
Total Medicare Payment Amount |
791378.1 |
Total Medicare Standardized Payment Amount |
784321.83 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
3207 |
Number Of Medicare Beneficiaries With Drug Services |
38 |
Total Drug Submitted ChargeAmount |
25656 |
Total Drug Medicare AllowedAmount |
598.39 |
Total Drug Medicare PaymentAmount |
469.1 |
Total Drug Medicare Standardized Payment Amount |
469.1 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
109 |
Number Of Medical Services |
2085 |
Number Of Medicare Beneficiaries With Medical Services |
560 |
Total Medical Submitted Charge Amount |
5427910.91 |
Total Medical Medicare Allowed Amount |
1017389.75 |
Total Medical Medicare Payment Amount |
790909 |
Total Medical Medicare Standardized Payment Amount |
783852.73 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
80 |
Number Of Beneficiaries Age 65 to 74 |
216 |
Number Of Beneficiaries Age 75 to 84 |
172 |
Number Of Beneficiaries Age Greater 84 |
92 |
Number Of Female Beneficiaries |
250 |
Number Of Male Beneficiaries |
310 |
Number Of Non Hispanic White Beneficiaries |
416 |
Number Of Black or African American Beneficiaries |
79 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
42 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
452 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
108 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
43 |
Percent Of With Chronic Kidney Disease |
53 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
63 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.4736 |