| National Provider Identifier [NPI]: | 1871608836 |
| Last Name Of The Provider | GLEYSTEEN |
| First Name Of The Provider | SUZANNE |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 637 WASHINGTON ST |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | BROOKLINE |
| Zip Code Of The Provider | 024464500 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 41 |
| Number Of Services | 1644 |
| Number Of Medicare Beneficiaries | 373 |
| Total Submitted Charge Amount | 259387 |
| Total Medicare Allowed Amount | 122529.76 |
| Total Medicare Payment Amount | 94447.08 |
| Total Medicare Standardized Payment Amount | 92993.79 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 157 |
| Number Of Medicare Beneficiaries With Drug Services | 131 |
| Total Drug Submitted ChargeAmount | 7589 |
| Total Drug Medicare AllowedAmount | 5326.2 |
| Total Drug Medicare PaymentAmount | 5028.66 |
| Total Drug Medicare Standardized Payment Amount | 5028.66 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 32 |
| Number Of Medical Services | 1487 |
| Number Of Medicare Beneficiaries With Medical Services | 373 |
| Total Medical Submitted Charge Amount | 251798 |
| Total Medical Medicare Allowed Amount | 117203.56 |
| Total Medical Medicare Payment Amount | 89418.42 |
| Total Medical Medicare Standardized Payment Amount | 87965.13 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 50 |
| Number Of Beneficiaries Age 65 to 74 | 212 |
| Number Of Beneficiaries Age 75 to 84 | 84 |
| Number Of Beneficiaries Age Greater 84 | 27 |
| Number Of Female Beneficiaries | 328 |
| Number Of Male Beneficiaries | 45 |
| Number Of Non Hispanic White Beneficiaries | 337 |
| 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 | 16 |
| Number Of Beneficiaries With Medicare Only Entitlement | 334 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 39 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 3 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 7 |
| Percent Of With Chronic Kidney Disease | 9 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 5 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 12 |
| Percent Of With Hyperlipidemia | 32 |
| Percent Of With Hypertension | 44 |
| Percent Of With Ischemic Heart Disease | 13 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9125 |