| National Provider Identifier [NPI]: | 1245281872 |
| Last Name Of The Provider | FONTENEAU |
| First Name Of The Provider | ANNETTE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MSN, RNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 333 SCHOOL ST |
| Street Address 2 Of The Provider | SUITE #216 |
| City Of The Provider | PAWTUCKET |
| Zip Code Of The Provider | 028605334 |
| State Code Of The Provider | RI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 37 |
| Number Of Services | 7887 |
| Number Of Medicare Beneficiaries | 684 |
| Total Submitted Charge Amount | 410805 |
| Total Medicare Allowed Amount | 207005.55 |
| Total Medicare Payment Amount | 150882.16 |
| Total Medicare Standardized Payment Amount | 166346.18 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 26 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 552 |
| Total Drug Medicare AllowedAmount | 523.22 |
| Total Drug Medicare PaymentAmount | 398.76 |
| Total Drug Medicare Standardized Payment Amount | 398.76 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 35 |
| Number Of Medical Services | 7861 |
| Number Of Medicare Beneficiaries With Medical Services | 684 |
| Total Medical Submitted Charge Amount | 410253 |
| Total Medical Medicare Allowed Amount | 206482.33 |
| Total Medical Medicare Payment Amount | 150483.4 |
| Total Medical Medicare Standardized Payment Amount | 165947.42 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 69 |
| Number Of Beneficiaries Age 65 to 74 | 354 |
| Number Of Beneficiaries Age 75 to 84 | 182 |
| Number Of Beneficiaries Age Greater 84 | 79 |
| Number Of Female Beneficiaries | 468 |
| Number Of Male Beneficiaries | 216 |
| Number Of Non Hispanic White Beneficiaries | 620 |
| Number Of Black or African American Beneficiaries | 14 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 33 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 597 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 87 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9285 |