| National Provider Identifier [NPI]: | 1023015211 |
| Last Name Of The Provider | BETTERIDGE |
| First Name Of The Provider | LOREN |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3733 S THOMPSON AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | TACOMA |
| Zip Code Of The Provider | 984185013 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 36 |
| Number Of Services | 1438 |
| Number Of Medicare Beneficiaries | 210 |
| Total Submitted Charge Amount | 131254.02 |
| Total Medicare Allowed Amount | 88914.98 |
| Total Medicare Payment Amount | 60875 |
| Total Medicare Standardized Payment Amount | 64126.45 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 261 |
| Number Of Medicare Beneficiaries With Drug Services | 81 |
| Total Drug Submitted ChargeAmount | 7823.02 |
| Total Drug Medicare AllowedAmount | 6389.3 |
| Total Drug Medicare PaymentAmount | 5317.5 |
| Total Drug Medicare Standardized Payment Amount | 5317.5 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 29 |
| Number Of Medical Services | 1177 |
| Number Of Medicare Beneficiaries With Medical Services | 210 |
| Total Medical Submitted Charge Amount | 123431 |
| Total Medical Medicare Allowed Amount | 82525.68 |
| Total Medical Medicare Payment Amount | 55557.5 |
| Total Medical Medicare Standardized Payment Amount | 58808.95 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 30 |
| Number Of Beneficiaries Age 65 to 74 | 100 |
| Number Of Beneficiaries Age 75 to 84 | 44 |
| Number Of Beneficiaries Age Greater 84 | 36 |
| Number Of Female Beneficiaries | 114 |
| Number Of Male Beneficiaries | 96 |
| Number Of Non Hispanic White Beneficiaries | 168 |
| Number Of Black or African American Beneficiaries | 15 |
| Number Of AsianPacific Islander Beneficiaries | 13 |
| 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 | 165 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 45 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 16 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 57 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0426 |