| National Provider Identifier [NPI]: | 1265431274 |
| Last Name Of The Provider | EISEN |
| First Name Of The Provider | ELKA |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D., FAAD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1595 E RIVER RD |
| Street Address 2 Of The Provider | SUITE 201 |
| City Of The Provider | TUCSON |
| Zip Code Of The Provider | 857185981 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 51 |
| Number Of Services | 9559 |
| Number Of Medicare Beneficiaries | 2109 |
| Total Submitted Charge Amount | 643417 |
| Total Medicare Allowed Amount | 476422.87 |
| Total Medicare Payment Amount | 330163.69 |
| Total Medicare Standardized Payment Amount | 328874.94 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 197 |
| Number Of Medicare Beneficiaries With Drug Services | 59 |
| Total Drug Submitted ChargeAmount | 997 |
| Total Drug Medicare AllowedAmount | 359.85 |
| Total Drug Medicare PaymentAmount | 265 |
| Total Drug Medicare Standardized Payment Amount | 265 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 49 |
| Number Of Medical Services | 9362 |
| Number Of Medicare Beneficiaries With Medical Services | 2109 |
| Total Medical Submitted Charge Amount | 642420 |
| Total Medical Medicare Allowed Amount | 476063.02 |
| Total Medical Medicare Payment Amount | 329898.69 |
| Total Medical Medicare Standardized Payment Amount | 328609.94 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 42 |
| Number Of Beneficiaries Age 65 to 74 | 1206 |
| Number Of Beneficiaries Age 75 to 84 | 655 |
| Number Of Beneficiaries Age Greater 84 | 206 |
| Number Of Female Beneficiaries | 1220 |
| Number Of Male Beneficiaries | 889 |
| Number Of Non Hispanic White Beneficiaries | 2026 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 37 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 27 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2067 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 42 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 7 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 14 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 49 |
| Percent Of With Ischemic Heart Disease | 20 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 2 |
| Average HCC Risk Score Of Beneficiaries | 0.7753 |