National Provider Identifier [NPI]: |
1043305113 |
Last Name Of The Provider |
EISENHART |
First Name Of The Provider |
PAULA |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7565 MISSION VALLEY RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAN DIEGO |
Zip Code Of The Provider |
921084431 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
34 |
Number Of Services |
1136 |
Number Of Medicare Beneficiaries |
274 |
Total Submitted Charge Amount |
164478 |
Total Medicare Allowed Amount |
84122.69 |
Total Medicare Payment Amount |
60921.85 |
Total Medicare Standardized Payment Amount |
58734.16 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
13 |
Number Of Drug Services |
231 |
Number Of Medicare Beneficiaries With Drug Services |
114 |
Total Drug Submitted ChargeAmount |
8643 |
Total Drug Medicare AllowedAmount |
2970.71 |
Total Drug Medicare PaymentAmount |
2893 |
Total Drug Medicare Standardized Payment Amount |
2893 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
21 |
Number Of Medical Services |
905 |
Number Of Medicare Beneficiaries With Medical Services |
274 |
Total Medical Submitted Charge Amount |
155835 |
Total Medical Medicare Allowed Amount |
81151.98 |
Total Medical Medicare Payment Amount |
58028.85 |
Total Medical Medicare Standardized Payment Amount |
55841.16 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
14 |
Number Of Beneficiaries Age 65 to 74 |
132 |
Number Of Beneficiaries Age 75 to 84 |
73 |
Number Of Beneficiaries Age Greater 84 |
55 |
Number Of Female Beneficiaries |
215 |
Number Of Male Beneficiaries |
59 |
Number Of Non Hispanic White Beneficiaries |
237 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
18 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
261 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
13 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
7 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
18 |
Percent Of With Hyperlipidemia |
37 |
Percent Of With Hypertension |
49 |
Percent Of With Ischemic Heart Disease |
21 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9989 |