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I like to do extreme Dr. Mario instead of Tetris. The original NES Dr. Mario repeats the same speed and parameters as level 20 over and over. The level counter stops at 24, where it repeats endlessly. There's a Tetris and Dr. Mario game for SNES that features both games in one cartridge. In this game the Dr. Mario levels continue to increase in number and speed. On low mode (lower speed and less points) I managed to get past 99 using save/load between levels where the first digit is revealed to be hexadecimal. It goes to A0 after that. For "med" speed I think I got around level 70 and for "hi" I got past 50.

There is one difference between the 3 modes other than starting at lower speeds. Prior to the pills starting to fall inside the bottle, there's a pill toss complements of Dr. Mario. The pill toss is slowest in low speed and moderate in med speed. This slow toss gives you more time to decide on another move.

I initially started using a mid-game save/load trick to get "hi" mode past 99 into B0 or a little higher. I had my left hand pinky finger on a keyboard save button, and if I played a good series of moves, I'd save mid-game. I had a back up save to start the level over if I saved myself in a guaranteed disaster. I abandoned this method for the more real and satisfying, level by level approach. I recorded a screen save of playing for over 4 minutes to finally get a winning run on a "hi" level that was over 50.

Playing this really pushes your brain to the limits of its ability to think quickly. I could possibly get better by learning hypertapping or even rolling to help move pills over as fast as possible.