| National Provider Identifier [NPI]: | 1558466029 |
| Last Name Of The Provider | EISSMANN |
| First Name Of The Provider | EDWARD |
| 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 | 328 S STILLAGUAMISH AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | ARLINGTON |
| Zip Code Of The Provider | 982231660 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 60 |
| Number Of Services | 533 |
| Number Of Medicare Beneficiaries | 127 |
| Total Submitted Charge Amount | 117232.75 |
| Total Medicare Allowed Amount | 60646.42 |
| Total Medicare Payment Amount | 44468.07 |
| Total Medicare Standardized Payment Amount | 46546.61 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 140 |
| Number Of Medicare Beneficiaries With Drug Services | 23 |
| Total Drug Submitted ChargeAmount | 4874 |
| Total Drug Medicare AllowedAmount | 3136.27 |
| Total Drug Medicare PaymentAmount | 2112.35 |
| Total Drug Medicare Standardized Payment Amount | 2112.35 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 56 |
| Number Of Medical Services | 393 |
| Number Of Medicare Beneficiaries With Medical Services | 127 |
| Total Medical Submitted Charge Amount | 112358.75 |
| Total Medical Medicare Allowed Amount | 57510.15 |
| Total Medical Medicare Payment Amount | 42355.72 |
| Total Medical Medicare Standardized Payment Amount | 44434.26 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 18 |
| Number Of Beneficiaries Age 65 to 74 | 53 |
| Number Of Beneficiaries Age 75 to 84 | 35 |
| Number Of Beneficiaries Age Greater 84 | 21 |
| Number Of Female Beneficiaries | 76 |
| Number Of Male Beneficiaries | 51 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 102 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 25 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 38 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 68 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1225 |