| National Provider Identifier [NPI]: | 1932159530 |
| Last Name Of The Provider | AFONICHEVA |
| First Name Of The Provider | LUDMILA |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2204 TORRANCE BLVD |
| Street Address 2 Of The Provider | STE 105 |
| City Of The Provider | TORRANCE |
| Zip Code Of The Provider | 905012544 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 57 |
| Number Of Services | 1744 |
| Number Of Medicare Beneficiaries | 160 |
| Total Submitted Charge Amount | 204560 |
| Total Medicare Allowed Amount | 155604.81 |
| Total Medicare Payment Amount | 118581.59 |
| Total Medicare Standardized Payment Amount | 110211.13 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 237 |
| Number Of Medicare Beneficiaries With Drug Services | 86 |
| Total Drug Submitted ChargeAmount | 7630 |
| Total Drug Medicare AllowedAmount | 3300.96 |
| Total Drug Medicare PaymentAmount | 2885.02 |
| Total Drug Medicare Standardized Payment Amount | 2885.02 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 51 |
| Number Of Medical Services | 1507 |
| Number Of Medicare Beneficiaries With Medical Services | 160 |
| Total Medical Submitted Charge Amount | 196930 |
| Total Medical Medicare Allowed Amount | 152303.85 |
| Total Medical Medicare Payment Amount | 115696.57 |
| Total Medical Medicare Standardized Payment Amount | 107326.11 |
| Average Age Of Beneficiaries | 80 |
| Number Of Beneficiaries Age Less65 | 11 |
| Number Of Beneficiaries Age 65 to 74 | 29 |
| Number Of Beneficiaries Age 75 to 84 | 57 |
| Number Of Beneficiaries Age Greater 84 | 63 |
| Number Of Female Beneficiaries | 106 |
| Number Of Male Beneficiaries | 54 |
| Number Of Non Hispanic White Beneficiaries | 122 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 17 |
| 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 | 57 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 103 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 33 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 19 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 2.0154 |