| National Provider Identifier [NPI]: | 1487655445 |
| Last Name Of The Provider | EISENMAN |
| First Name Of The Provider | MALLORY |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1900 RITTENHOUSE SQ |
| Street Address 2 Of The Provider | SUITE C3 |
| City Of The Provider | PHILADELPHIA |
| Zip Code Of The Provider | 191035767 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 45 |
| Number Of Services | 2561 |
| Number Of Medicare Beneficiaries | 669 |
| Total Submitted Charge Amount | 242085 |
| Total Medicare Allowed Amount | 157635.85 |
| Total Medicare Payment Amount | 114628.97 |
| Total Medicare Standardized Payment Amount | 109906.91 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 175 |
| Number Of Medicare Beneficiaries With Drug Services | 82 |
| Total Drug Submitted ChargeAmount | 2495 |
| Total Drug Medicare AllowedAmount | 926.01 |
| Total Drug Medicare PaymentAmount | 726.16 |
| Total Drug Medicare Standardized Payment Amount | 726.16 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 43 |
| Number Of Medical Services | 2386 |
| Number Of Medicare Beneficiaries With Medical Services | 669 |
| Total Medical Submitted Charge Amount | 239590 |
| Total Medical Medicare Allowed Amount | 156709.84 |
| Total Medical Medicare Payment Amount | 113902.81 |
| Total Medical Medicare Standardized Payment Amount | 109180.75 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 20 |
| Number Of Beneficiaries Age 65 to 74 | 233 |
| Number Of Beneficiaries Age 75 to 84 | 234 |
| Number Of Beneficiaries Age Greater 84 | 182 |
| Number Of Female Beneficiaries | 429 |
| Number Of Male Beneficiaries | 240 |
| Number Of Non Hispanic White Beneficiaries | 591 |
| Number Of Black or African American Beneficiaries | 54 |
| 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 | 644 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 25 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1835 |