| National Provider Identifier [NPI]: | 1043591225 |
| Last Name Of The Provider | TREIBER |
| First Name Of The Provider | SUEANN |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | NP-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4961 ROBERTS RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | HILLIARD |
| Zip Code Of The Provider | 430268129 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 19 |
| Number Of Services | 105 |
| Number Of Medicare Beneficiaries | 64 |
| Total Submitted Charge Amount | 11646.88 |
| Total Medicare Allowed Amount | 4711.66 |
| Total Medicare Payment Amount | 3567.99 |
| Total Medicare Standardized Payment Amount | 4274.91 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 12 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 316.88 |
| Total Drug Medicare AllowedAmount | 316.88 |
| Total Drug Medicare PaymentAmount | 310.54 |
| Total Drug Medicare Standardized Payment Amount | 310.54 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 15 |
| Number Of Medical Services | 93 |
| Number Of Medicare Beneficiaries With Medical Services | 64 |
| Total Medical Submitted Charge Amount | 11330 |
| Total Medical Medicare Allowed Amount | 4394.78 |
| Total Medical Medicare Payment Amount | 3257.45 |
| Total Medical Medicare Standardized Payment Amount | 3964.37 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 17 |
| Number Of Beneficiaries Age 65 to 74 | 33 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 33 |
| Number Of Male Beneficiaries | 31 |
| 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 | 53 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 11 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 41 |
| Percent Of With Hypertension | 48 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.7812 |