| National Provider Identifier [NPI]: | 1538137435 |
| Last Name Of The Provider | DELACRUZ |
| First Name Of The Provider | EILEEN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4410 106TH ST SW |
| Street Address 2 Of The Provider | |
| City Of The Provider | MUKILTEO |
| Zip Code Of The Provider | 982754700 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 143 |
| Number Of Services | 3577 |
| Number Of Medicare Beneficiaries | 176 |
| Total Submitted Charge Amount | 219905.25 |
| Total Medicare Allowed Amount | 95427.07 |
| Total Medicare Payment Amount | 74441.78 |
| Total Medicare Standardized Payment Amount | 76299.19 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 1301 |
| Number Of Medicare Beneficiaries With Drug Services | 51 |
| Total Drug Submitted ChargeAmount | 5267.5 |
| Total Drug Medicare AllowedAmount | 2479.04 |
| Total Drug Medicare PaymentAmount | 2140.3 |
| Total Drug Medicare Standardized Payment Amount | 2140.3 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 134 |
| Number Of Medical Services | 2276 |
| Number Of Medicare Beneficiaries With Medical Services | 175 |
| Total Medical Submitted Charge Amount | 214637.75 |
| Total Medical Medicare Allowed Amount | 92948.03 |
| Total Medical Medicare Payment Amount | 72301.48 |
| Total Medical Medicare Standardized Payment Amount | 74158.89 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 12 |
| Number Of Beneficiaries Age 65 to 74 | 80 |
| Number Of Beneficiaries Age 75 to 84 | 55 |
| Number Of Beneficiaries Age Greater 84 | 29 |
| Number Of Female Beneficiaries | 133 |
| Number Of Male Beneficiaries | 43 |
| Number Of Non Hispanic White Beneficiaries | 162 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 7 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 18 |
| Percent Of With Hyperlipidemia | 39 |
| Percent Of With Hypertension | 53 |
| Percent Of With Ischemic Heart Disease | 15 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9022 |