| National Provider Identifier [NPI]: | 1063575199 |
| Last Name Of The Provider | SPAK |
| First Name Of The Provider | CEDRIC |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3409 WORTH ST |
| Street Address 2 Of The Provider | SUITE 710 |
| City Of The Provider | DALLAS |
| Zip Code Of The Provider | 752462029 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Infectious Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 79 |
| Number Of Services | 230847 |
| Number Of Medicare Beneficiaries | 803 |
| Total Submitted Charge Amount | 4633290.66 |
| Total Medicare Allowed Amount | 1670072.83 |
| Total Medicare Payment Amount | 1254167.2 |
| Total Medicare Standardized Payment Amount | 1255853.29 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 46 |
| Number Of Drug Services | 225322 |
| Number Of Medicare Beneficiaries With Drug Services | 264 |
| Total Drug Submitted ChargeAmount | 3206656.66 |
| Total Drug Medicare AllowedAmount | 1239971.7 |
| Total Drug Medicare PaymentAmount | 929127.8 |
| Total Drug Medicare Standardized Payment Amount | 929127.8 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 33 |
| Number Of Medical Services | 5525 |
| Number Of Medicare Beneficiaries With Medical Services | 803 |
| Total Medical Submitted Charge Amount | 1426634 |
| Total Medical Medicare Allowed Amount | 430101.13 |
| Total Medical Medicare Payment Amount | 325039.4 |
| Total Medical Medicare Standardized Payment Amount | 326725.49 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 282 |
| Number Of Beneficiaries Age 65 to 74 | 269 |
| Number Of Beneficiaries Age 75 to 84 | 189 |
| Number Of Beneficiaries Age Greater 84 | 63 |
| Number Of Female Beneficiaries | 452 |
| Number Of Male Beneficiaries | 351 |
| Number Of Non Hispanic White Beneficiaries | 539 |
| Number Of Black or African American Beneficiaries | 170 |
| Number Of AsianPacific Islander Beneficiaries | 14 |
| Number Of Hispanic Beneficiaries | 66 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 615 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 188 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 56 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 29 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 2.9072 |