National Provider Identifier [NPI]: |
1700040573 |
Last Name Of The Provider |
SERFIN |
First Name Of The Provider |
JENNIFER |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3600 NW SAMARITAN DR |
Street Address 2 Of The Provider |
SUITE 1N010 |
City Of The Provider |
CORVALLIS |
Zip Code Of The Provider |
973303737 |
State Code Of The Provider |
OR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
49 |
Number Of Services |
301 |
Number Of Medicare Beneficiaries |
81 |
Total Submitted Charge Amount |
169239 |
Total Medicare Allowed Amount |
52147.04 |
Total Medicare Payment Amount |
38257.51 |
Total Medicare Standardized Payment Amount |
42536.3 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
49 |
Number Of Medical Services |
301 |
Number Of Medicare Beneficiaries With Medical Services |
81 |
Total Medical Submitted Charge Amount |
169239 |
Total Medical Medicare Allowed Amount |
52147.04 |
Total Medical Medicare Payment Amount |
38257.51 |
Total Medical Medicare Standardized Payment Amount |
42536.3 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
20 |
Number Of Beneficiaries Age 65 to 74 |
27 |
Number Of Beneficiaries Age 75 to 84 |
20 |
Number Of Beneficiaries Age Greater 84 |
14 |
Number Of Female Beneficiaries |
40 |
Number Of Male Beneficiaries |
41 |
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 |
59 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
22 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
16 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
38 |
Percent Of With Chronic Kidney Disease |
54 |
Percent Of With Chronic Obstructive Pulmonary Disease |
38 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.9603 |