| National Provider Identifier [NPI]: | 1750544243 |
| Last Name Of The Provider | SPETTEL |
| First Name Of The Provider | SARA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9135 SW BARNES RD |
| Street Address 2 Of The Provider | SUITE 663 |
| City Of The Provider | PORTLAND |
| Zip Code Of The Provider | 972256646 |
| State Code Of The Provider | OR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 95 |
| Number Of Services | 4804 |
| Number Of Medicare Beneficiaries | 393 |
| Total Submitted Charge Amount | 581679.8 |
| Total Medicare Allowed Amount | 212667.62 |
| Total Medicare Payment Amount | 161079.26 |
| Total Medicare Standardized Payment Amount | 161862.23 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 2974 |
| Number Of Medicare Beneficiaries With Drug Services | 29 |
| Total Drug Submitted ChargeAmount | 36532.8 |
| Total Drug Medicare AllowedAmount | 27735.16 |
| Total Drug Medicare PaymentAmount | 21729.64 |
| Total Drug Medicare Standardized Payment Amount | 21729.64 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 86 |
| Number Of Medical Services | 1830 |
| Number Of Medicare Beneficiaries With Medical Services | 393 |
| Total Medical Submitted Charge Amount | 545147 |
| Total Medical Medicare Allowed Amount | 184932.46 |
| Total Medical Medicare Payment Amount | 139349.62 |
| Total Medical Medicare Standardized Payment Amount | 140132.59 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 48 |
| Number Of Beneficiaries Age 65 to 74 | 158 |
| Number Of Beneficiaries Age 75 to 84 | 131 |
| Number Of Beneficiaries Age Greater 84 | 56 |
| Number Of Female Beneficiaries | 213 |
| Number Of Male Beneficiaries | 180 |
| Number Of Non Hispanic White Beneficiaries | 351 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 13 |
| Number Of Hispanic Beneficiaries | 13 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 331 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 62 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 22 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.2915 |