| National Provider Identifier [NPI]: | 1265475024 |
| Last Name Of The Provider | SPIEGLER |
| First Name Of The Provider | ETHAN |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7253 AMBASSADOR RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | BALTIMORE |
| Zip Code Of The Provider | 212442710 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nuclear Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 64 |
| Number Of Services | 6261 |
| Number Of Medicare Beneficiaries | 3825 |
| Total Submitted Charge Amount | 4373315.18 |
| Total Medicare Allowed Amount | 2078978.74 |
| Total Medicare Payment Amount | 1611078.3 |
| Total Medicare Standardized Payment Amount | 1590354.5 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 130 |
| Number Of Medicare Beneficiaries With Drug Services | 67 |
| Total Drug Submitted ChargeAmount | 822.34 |
| Total Drug Medicare AllowedAmount | 457.85 |
| Total Drug Medicare PaymentAmount | 325.25 |
| Total Drug Medicare Standardized Payment Amount | 325.25 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 61 |
| Number Of Medical Services | 6131 |
| Number Of Medicare Beneficiaries With Medical Services | 3825 |
| Total Medical Submitted Charge Amount | 4372492.84 |
| Total Medical Medicare Allowed Amount | 2078520.89 |
| Total Medical Medicare Payment Amount | 1610753.05 |
| Total Medical Medicare Standardized Payment Amount | 1590029.25 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 515 |
| Number Of Beneficiaries Age 65 to 74 | 1583 |
| Number Of Beneficiaries Age 75 to 84 | 1206 |
| Number Of Beneficiaries Age Greater 84 | 521 |
| Number Of Female Beneficiaries | 2178 |
| Number Of Male Beneficiaries | 1647 |
| Number Of Non Hispanic White Beneficiaries | 2859 |
| Number Of Black or African American Beneficiaries | 829 |
| Number Of AsianPacific Islander Beneficiaries | 47 |
| Number Of Hispanic Beneficiaries | 48 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 3204 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 621 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 36 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.8048 |