| National Provider Identifier [NPI]: | 1194749283 |
| Last Name Of The Provider | MARIANO |
| First Name Of The Provider | DONNA |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | APRN |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 67 MASONIC AVE |
| Street Address 2 Of The Provider | SUITE 3100 |
| City Of The Provider | WALLINGFORD |
| Zip Code Of The Provider | 064923095 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 30 |
| Number Of Services | 961 |
| Number Of Medicare Beneficiaries | 341 |
| Total Submitted Charge Amount | 143500.51 |
| Total Medicare Allowed Amount | 62834.94 |
| Total Medicare Payment Amount | 45263.55 |
| Total Medicare Standardized Payment Amount | 49704.78 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 89 |
| Number Of Medicare Beneficiaries With Drug Services | 69 |
| Total Drug Submitted ChargeAmount | 2305.01 |
| Total Drug Medicare AllowedAmount | 1383.86 |
| Total Drug Medicare PaymentAmount | 1335.97 |
| Total Drug Medicare Standardized Payment Amount | 1335.97 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 23 |
| Number Of Medical Services | 872 |
| Number Of Medicare Beneficiaries With Medical Services | 341 |
| Total Medical Submitted Charge Amount | 141195.5 |
| Total Medical Medicare Allowed Amount | 61451.08 |
| Total Medical Medicare Payment Amount | 43927.58 |
| Total Medical Medicare Standardized Payment Amount | 48368.81 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 57 |
| Number Of Beneficiaries Age 65 to 74 | 114 |
| Number Of Beneficiaries Age 75 to 84 | 103 |
| Number Of Beneficiaries Age Greater 84 | 67 |
| Number Of Female Beneficiaries | 216 |
| Number Of Male Beneficiaries | 125 |
| Number Of Non Hispanic White Beneficiaries | 300 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 22 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 222 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 119 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1442 |