| National Provider Identifier [NPI]: | 1417971359 |
| Last Name Of The Provider | CIESA |
| First Name Of The Provider | MARY |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | NURSE PRACTITIONER |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 224 W EXCHANGE ST |
| Street Address 2 Of The Provider | SUITE330 |
| City Of The Provider | AKRON |
| Zip Code Of The Provider | 443021704 |
| 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 | 53 |
| Number Of Services | 1446 |
| Number Of Medicare Beneficiaries | 349 |
| Total Submitted Charge Amount | 101388.9 |
| Total Medicare Allowed Amount | 62776.08 |
| Total Medicare Payment Amount | 44644.59 |
| Total Medicare Standardized Payment Amount | 55247.01 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 216 |
| Number Of Medicare Beneficiaries With Drug Services | 95 |
| Total Drug Submitted ChargeAmount | 3996.9 |
| Total Drug Medicare AllowedAmount | 1340.11 |
| Total Drug Medicare PaymentAmount | 1255.78 |
| Total Drug Medicare Standardized Payment Amount | 1255.78 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 42 |
| Number Of Medical Services | 1230 |
| Number Of Medicare Beneficiaries With Medical Services | 349 |
| Total Medical Submitted Charge Amount | 97392 |
| Total Medical Medicare Allowed Amount | 61435.97 |
| Total Medical Medicare Payment Amount | 43388.81 |
| Total Medical Medicare Standardized Payment Amount | 53991.23 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 26 |
| Number Of Beneficiaries Age 65 to 74 | 179 |
| Number Of Beneficiaries Age 75 to 84 | 106 |
| Number Of Beneficiaries Age Greater 84 | 38 |
| Number Of Female Beneficiaries | 245 |
| Number Of Male Beneficiaries | 104 |
| 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 | 315 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 34 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.068 |