| National Provider Identifier [NPI]: | 1245233022 |
| Last Name Of The Provider | SPENCER |
| First Name Of The Provider | JOSE |
| 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 | 2411 SARA RIDGE LANE |
| Street Address 2 Of The Provider | |
| City Of The Provider | KATY |
| Zip Code Of The Provider | 77450 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 89 |
| Number Of Services | 4787 |
| Number Of Medicare Beneficiaries | 2389 |
| Total Submitted Charge Amount | 562354 |
| Total Medicare Allowed Amount | 118866.68 |
| Total Medicare Payment Amount | 91165.11 |
| Total Medicare Standardized Payment Amount | 91114.09 |
| 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 | 89 |
| Number Of Medical Services | 4787 |
| Number Of Medicare Beneficiaries With Medical Services | 2389 |
| Total Medical Submitted Charge Amount | 562354 |
| Total Medical Medicare Allowed Amount | 118866.68 |
| Total Medical Medicare Payment Amount | 91165.11 |
| Total Medical Medicare Standardized Payment Amount | 91114.09 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 577 |
| Number Of Beneficiaries Age 65 to 74 | 723 |
| Number Of Beneficiaries Age 75 to 84 | 651 |
| Number Of Beneficiaries Age Greater 84 | 438 |
| Number Of Female Beneficiaries | 1388 |
| Number Of Male Beneficiaries | 1001 |
| Number Of Non Hispanic White Beneficiaries | 1550 |
| Number Of Black or African American Beneficiaries | 462 |
| Number Of AsianPacific Islander Beneficiaries | 86 |
| Number Of Hispanic Beneficiaries | 266 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1535 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 854 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 31 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 51 |
| Percent Of With Chronic Kidney Disease | 51 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 36 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 50 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 61 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 21 |
| Average HCC Risk Score Of Beneficiaries | 2.4293 |