National Provider Identifier [NPI]: |
1184654055 |
Last Name Of The Provider |
SERIO |
First Name Of The Provider |
THOMAS |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1802 MICCOSUKEE COMMONS DRIVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
TALLAHASSEE |
Zip Code Of The Provider |
323085432 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
55 |
Number Of Services |
1374 |
Number Of Medicare Beneficiaries |
101 |
Total Submitted Charge Amount |
106674 |
Total Medicare Allowed Amount |
69161.83 |
Total Medicare Payment Amount |
50425.47 |
Total Medicare Standardized Payment Amount |
50859.66 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
476 |
Number Of Medicare Beneficiaries With Drug Services |
61 |
Total Drug Submitted ChargeAmount |
9641 |
Total Drug Medicare AllowedAmount |
2544.85 |
Total Drug Medicare PaymentAmount |
2289.34 |
Total Drug Medicare Standardized Payment Amount |
2289.34 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
45 |
Number Of Medical Services |
898 |
Number Of Medicare Beneficiaries With Medical Services |
101 |
Total Medical Submitted Charge Amount |
97033 |
Total Medical Medicare Allowed Amount |
66616.98 |
Total Medical Medicare Payment Amount |
48136.13 |
Total Medical Medicare Standardized Payment Amount |
48570.32 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
53 |
Number Of Beneficiaries Age 75 to 84 |
25 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
53 |
Number Of Male Beneficiaries |
48 |
Number Of Non Hispanic White Beneficiaries |
89 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
|
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
19 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
27 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9972 |