| National Provider Identifier [NPI]: | 1043306335 |
| Last Name Of The Provider | DELEAN-BOTKIN |
| First Name Of The Provider | SUSAN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | CRNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8579 COMMERCE DR STE 106 |
| Street Address 2 Of The Provider | |
| City Of The Provider | EASTON |
| Zip Code Of The Provider | 216017420 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 29 |
| Number Of Services | 2318 |
| Number Of Medicare Beneficiaries | 542 |
| Total Submitted Charge Amount | 194015 |
| Total Medicare Allowed Amount | 164628.7 |
| Total Medicare Payment Amount | 119417.17 |
| Total Medicare Standardized Payment Amount | 140301.83 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 74 |
| Number Of Medicare Beneficiaries With Drug Services | 68 |
| Total Drug Submitted ChargeAmount | 2190 |
| Total Drug Medicare AllowedAmount | 1710.24 |
| Total Drug Medicare PaymentAmount | 1676.03 |
| Total Drug Medicare Standardized Payment Amount | 1676.03 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 25 |
| Number Of Medical Services | 2244 |
| Number Of Medicare Beneficiaries With Medical Services | 542 |
| Total Medical Submitted Charge Amount | 191825 |
| Total Medical Medicare Allowed Amount | 162918.46 |
| Total Medical Medicare Payment Amount | 117741.14 |
| Total Medical Medicare Standardized Payment Amount | 138625.8 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 70 |
| Number Of Beneficiaries Age 65 to 74 | 214 |
| Number Of Beneficiaries Age 75 to 84 | 157 |
| Number Of Beneficiaries Age Greater 84 | 101 |
| Number Of Female Beneficiaries | 397 |
| Number Of Male Beneficiaries | 145 |
| Number Of Non Hispanic White Beneficiaries | 457 |
| Number Of Black or African American Beneficiaries | 71 |
| Number Of AsianPacific Islander Beneficiaries | |
| 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 | 448 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 94 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 37 |
| Percent Of With Hypertension | 57 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 28 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 0.9838 |