| National Provider Identifier [NPI]: | 1821009036 |
| Last Name Of The Provider | SPADE |
| First Name Of The Provider | TIMOTHY |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 400 W MINERAL KING AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | VISALIA |
| Zip Code Of The Provider | 932916237 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 38 |
| Number Of Services | 1582 |
| Number Of Medicare Beneficiaries | 942 |
| Total Submitted Charge Amount | 605518 |
| Total Medicare Allowed Amount | 167306.82 |
| Total Medicare Payment Amount | 130419.41 |
| Total Medicare Standardized Payment Amount | 128974.7 |
| 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 | 38 |
| Number Of Medical Services | 1582 |
| Number Of Medicare Beneficiaries With Medical Services | 942 |
| Total Medical Submitted Charge Amount | 605518 |
| Total Medical Medicare Allowed Amount | 167306.82 |
| Total Medical Medicare Payment Amount | 130419.41 |
| Total Medical Medicare Standardized Payment Amount | 128974.7 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 196 |
| Number Of Beneficiaries Age 65 to 74 | 288 |
| Number Of Beneficiaries Age 75 to 84 | 241 |
| Number Of Beneficiaries Age Greater 84 | 217 |
| Number Of Female Beneficiaries | 532 |
| Number Of Male Beneficiaries | 410 |
| Number Of Non Hispanic White Beneficiaries | 563 |
| Number Of Black or African American Beneficiaries | 20 |
| Number Of AsianPacific Islander Beneficiaries | 33 |
| Number Of Hispanic Beneficiaries | 306 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 489 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 453 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 47 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 57 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 2.3435 |