| National Provider Identifier [NPI]: | 1356494231 |
| Last Name Of The Provider | SERURE |
| First Name Of The Provider | DONNA |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 327 E MAIN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | SMITHTOWN |
| Zip Code Of The Provider | 117872905 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 100 |
| Number Of Services | 19946 |
| Number Of Medicare Beneficiaries | 2851 |
| Total Submitted Charge Amount | 5187069 |
| Total Medicare Allowed Amount | 1887657.75 |
| Total Medicare Payment Amount | 1428017.3 |
| Total Medicare Standardized Payment Amount | 1209707.62 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 35 |
| Number Of Medicare Beneficiaries With Drug Services | 27 |
| Total Drug Submitted ChargeAmount | 525 |
| Total Drug Medicare AllowedAmount | 62.59 |
| Total Drug Medicare PaymentAmount | 41.98 |
| Total Drug Medicare Standardized Payment Amount | 41.98 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 99 |
| Number Of Medical Services | 19911 |
| Number Of Medicare Beneficiaries With Medical Services | 2851 |
| Total Medical Submitted Charge Amount | 5186544 |
| Total Medical Medicare Allowed Amount | 1887595.16 |
| Total Medical Medicare Payment Amount | 1427975.32 |
| Total Medical Medicare Standardized Payment Amount | 1209665.64 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 194 |
| Number Of Beneficiaries Age 65 to 74 | 1602 |
| Number Of Beneficiaries Age 75 to 84 | 823 |
| Number Of Beneficiaries Age Greater 84 | 232 |
| Number Of Female Beneficiaries | 1806 |
| Number Of Male Beneficiaries | 1045 |
| Number Of Non Hispanic White Beneficiaries | 2732 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 48 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 52 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2730 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 121 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9489 |