| National Provider Identifier [NPI]: | 1942469242 |
| Last Name Of The Provider | DELONG |
| First Name Of The Provider | BRIDGET |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1700 TUTTLE ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | BARABOO |
| Zip Code Of The Provider | 539133319 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 58 |
| Number Of Services | 491 |
| Number Of Medicare Beneficiaries | 125 |
| Total Submitted Charge Amount | 69121.69 |
| Total Medicare Allowed Amount | 26551.28 |
| Total Medicare Payment Amount | 20800.83 |
| Total Medicare Standardized Payment Amount | 21509.92 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 69 |
| Number Of Medicare Beneficiaries With Drug Services | 56 |
| Total Drug Submitted ChargeAmount | 2572 |
| Total Drug Medicare AllowedAmount | 1477.97 |
| Total Drug Medicare PaymentAmount | 1435.88 |
| Total Drug Medicare Standardized Payment Amount | 1435.88 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 48 |
| Number Of Medical Services | 422 |
| Number Of Medicare Beneficiaries With Medical Services | 125 |
| Total Medical Submitted Charge Amount | 66549.69 |
| Total Medical Medicare Allowed Amount | 25073.31 |
| Total Medical Medicare Payment Amount | 19364.95 |
| Total Medical Medicare Standardized Payment Amount | 20074.04 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 38 |
| Number Of Beneficiaries Age 65 to 74 | 46 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 91 |
| Number Of Male Beneficiaries | 34 |
| 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 | 72 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 53 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 47 |
| Percent Of With Ischemic Heart Disease | 23 |
| 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 | 1.0061 |