| National Provider Identifier [NPI]: | 1043475247 |
| Last Name Of The Provider | SPENCER |
| First Name Of The Provider | WARREN |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 350 N GRANDVIEW AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | DUBUQUE |
| Zip Code Of The Provider | 520016388 |
| State Code Of The Provider | IA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 196 |
| Number Of Services | 4668 |
| Number Of Medicare Beneficiaries | 2249 |
| Total Submitted Charge Amount | 521057 |
| Total Medicare Allowed Amount | 158938.72 |
| Total Medicare Payment Amount | 125119.35 |
| Total Medicare Standardized Payment Amount | 133154.99 |
| 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 | 196 |
| Number Of Medical Services | 4668 |
| Number Of Medicare Beneficiaries With Medical Services | 2249 |
| Total Medical Submitted Charge Amount | 521057 |
| Total Medical Medicare Allowed Amount | 158938.72 |
| Total Medical Medicare Payment Amount | 125119.35 |
| Total Medical Medicare Standardized Payment Amount | 133154.99 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 387 |
| Number Of Beneficiaries Age 65 to 74 | 843 |
| Number Of Beneficiaries Age 75 to 84 | 691 |
| Number Of Beneficiaries Age Greater 84 | 328 |
| Number Of Female Beneficiaries | 1341 |
| Number Of Male Beneficiaries | 908 |
| Number Of Non Hispanic White Beneficiaries | 2189 |
| Number Of Black or African American Beneficiaries | 21 |
| 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 | 17 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1676 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 573 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3832 |