| National Provider Identifier [NPI]: | 1144266495 |
| Last Name Of The Provider | BETTE |
| First Name Of The Provider | MARIANNE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD EAAFP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 77 MAIN STREET NORTH |
| Street Address 2 Of The Provider | |
| City Of The Provider | SOUTHBURY |
| Zip Code Of The Provider | 06488 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 51 |
| Number Of Services | 1065 |
| Number Of Medicare Beneficiaries | 185 |
| Total Submitted Charge Amount | 132955 |
| Total Medicare Allowed Amount | 91962.29 |
| Total Medicare Payment Amount | 66051.42 |
| Total Medicare Standardized Payment Amount | 63517.14 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 74 |
| Number Of Medicare Beneficiaries With Drug Services | 22 |
| Total Drug Submitted ChargeAmount | 955 |
| Total Drug Medicare AllowedAmount | 349.79 |
| Total Drug Medicare PaymentAmount | 322.87 |
| Total Drug Medicare Standardized Payment Amount | 322.87 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 45 |
| Number Of Medical Services | 991 |
| Number Of Medicare Beneficiaries With Medical Services | 185 |
| Total Medical Submitted Charge Amount | 132000 |
| Total Medical Medicare Allowed Amount | 91612.5 |
| Total Medical Medicare Payment Amount | 65728.55 |
| Total Medical Medicare Standardized Payment Amount | 63194.27 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 20 |
| Number Of Beneficiaries Age 65 to 74 | 83 |
| Number Of Beneficiaries Age 75 to 84 | 53 |
| Number Of Beneficiaries Age Greater 84 | 29 |
| Number Of Female Beneficiaries | 136 |
| Number Of Male Beneficiaries | 49 |
| Number Of Non Hispanic White Beneficiaries | 174 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 149 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 36 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 18 |
| Percent Of With Hyperlipidemia | 38 |
| Percent Of With Hypertension | 59 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 26 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9507 |