| National Provider Identifier [NPI]: | 1477599884 |
| Last Name Of The Provider | SPRAY |
| First Name Of The Provider | ANGELA |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7136 S OUTER ROAD 364 |
| Street Address 2 Of The Provider | |
| City Of The Provider | O FALLON |
| Zip Code Of The Provider | 633687756 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 33 |
| Number Of Services | 4567 |
| Number Of Medicare Beneficiaries | 700 |
| Total Submitted Charge Amount | 525598.29 |
| Total Medicare Allowed Amount | 246861.26 |
| Total Medicare Payment Amount | 174905.33 |
| Total Medicare Standardized Payment Amount | 177030.06 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 78 |
| Number Of Medicare Beneficiaries With Drug Services | 40 |
| Total Drug Submitted ChargeAmount | 39000 |
| Total Drug Medicare AllowedAmount | 19239.37 |
| Total Drug Medicare PaymentAmount | 14941.87 |
| Total Drug Medicare Standardized Payment Amount | 14941.87 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 32 |
| Number Of Medical Services | 4489 |
| Number Of Medicare Beneficiaries With Medical Services | 700 |
| Total Medical Submitted Charge Amount | 486598.29 |
| Total Medical Medicare Allowed Amount | 227621.89 |
| Total Medical Medicare Payment Amount | 159963.46 |
| Total Medical Medicare Standardized Payment Amount | 162088.19 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 41 |
| Number Of Beneficiaries Age 65 to 74 | 402 |
| Number Of Beneficiaries Age 75 to 84 | 194 |
| Number Of Beneficiaries Age Greater 84 | 63 |
| Number Of Female Beneficiaries | 423 |
| Number Of Male Beneficiaries | 277 |
| Number Of Non Hispanic White Beneficiaries | 689 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 682 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 18 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.8815 |