| National Provider Identifier [NPI]: | 1821204694 |
| Last Name Of The Provider | BOTTE |
| First Name Of The Provider | MARIE |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | APRN, BC-CDE |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 260 ELM ST |
| Street Address 2 Of The Provider | SUITE 105 |
| City Of The Provider | SOMERVILLE |
| Zip Code Of The Provider | 021442951 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 22 |
| Number Of Services | 325 |
| Number Of Medicare Beneficiaries | 57 |
| Total Submitted Charge Amount | 44248.04 |
| Total Medicare Allowed Amount | 21611.27 |
| Total Medicare Payment Amount | 15573.33 |
| Total Medicare Standardized Payment Amount | 17255.42 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 31 |
| Number Of Medicare Beneficiaries With Drug Services | 28 |
| Total Drug Submitted ChargeAmount | 1076.04 |
| Total Drug Medicare AllowedAmount | 640.81 |
| Total Drug Medicare PaymentAmount | 615.83 |
| Total Drug Medicare Standardized Payment Amount | 615.83 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 18 |
| Number Of Medical Services | 294 |
| Number Of Medicare Beneficiaries With Medical Services | 57 |
| Total Medical Submitted Charge Amount | 43172 |
| Total Medical Medicare Allowed Amount | 20970.46 |
| Total Medical Medicare Payment Amount | 14957.5 |
| Total Medical Medicare Standardized Payment Amount | 16639.59 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 20 |
| Number Of Beneficiaries Age 65 to 74 | 25 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 37 |
| Number Of Male Beneficiaries | 20 |
| 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 | 29 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 28 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 47 |
| Percent Of With Ischemic Heart Disease | 21 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9906 |