| National Provider Identifier [NPI]: | 1841287208 |
| Last Name Of The Provider | SERRA |
| First Name Of The Provider | JORGE |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3501 HEALTH CENTER BLVD |
| Street Address 2 Of The Provider | SUITE 2190 |
| City Of The Provider | FORT MYERS |
| Zip Code Of The Provider | 33908 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 54 |
| Number Of Services | 6901 |
| Number Of Medicare Beneficiaries | 741 |
| Total Submitted Charge Amount | 531727 |
| Total Medicare Allowed Amount | 344719.89 |
| Total Medicare Payment Amount | 251434.44 |
| Total Medicare Standardized Payment Amount | 241243.03 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 566 |
| Number Of Medicare Beneficiaries With Drug Services | 362 |
| Total Drug Submitted ChargeAmount | 20359 |
| Total Drug Medicare AllowedAmount | 13165.76 |
| Total Drug Medicare PaymentAmount | 12771.62 |
| Total Drug Medicare Standardized Payment Amount | 12771.62 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 45 |
| Number Of Medical Services | 6335 |
| Number Of Medicare Beneficiaries With Medical Services | 741 |
| Total Medical Submitted Charge Amount | 511368 |
| Total Medical Medicare Allowed Amount | 331554.13 |
| Total Medical Medicare Payment Amount | 238662.82 |
| Total Medical Medicare Standardized Payment Amount | 228471.41 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 379 |
| Number Of Beneficiaries Age 75 to 84 | 292 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 371 |
| Number Of Male Beneficiaries | 370 |
| Number Of Non Hispanic White Beneficiaries | 716 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 12 |
| Number Of American Indian Alaska Native Beneficiaries | |
| 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 | 13 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 7 |
| Percent Of With Diabetes | 17 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9144 |