| National Provider Identifier [NPI]: | 1386674000 |
| Last Name Of The Provider | AFFUE |
| First Name Of The Provider | THEODORE |
| 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 | 2061 ROSS AVE |
| Street Address 2 Of The Provider | SUITE A |
| City Of The Provider | EL CENTRO |
| Zip Code Of The Provider | 922433687 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 75 |
| Number Of Services | 13841 |
| Number Of Medicare Beneficiaries | 1951 |
| Total Submitted Charge Amount | 3636453.58 |
| Total Medicare Allowed Amount | 1489241.74 |
| Total Medicare Payment Amount | 1136395.22 |
| Total Medicare Standardized Payment Amount | 1102669.43 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 2339 |
| Number Of Medicare Beneficiaries With Drug Services | 545 |
| Total Drug Submitted ChargeAmount | 915593.5 |
| Total Drug Medicare AllowedAmount | 319149.64 |
| Total Drug Medicare PaymentAmount | 249198.61 |
| Total Drug Medicare Standardized Payment Amount | 249198.61 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 69 |
| Number Of Medical Services | 11502 |
| Number Of Medicare Beneficiaries With Medical Services | 1951 |
| Total Medical Submitted Charge Amount | 2720860.08 |
| Total Medical Medicare Allowed Amount | 1170092.1 |
| Total Medical Medicare Payment Amount | 887196.61 |
| Total Medical Medicare Standardized Payment Amount | 853470.82 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 276 |
| Number Of Beneficiaries Age 65 to 74 | 687 |
| Number Of Beneficiaries Age 75 to 84 | 698 |
| Number Of Beneficiaries Age Greater 84 | 290 |
| Number Of Female Beneficiaries | 446 |
| Number Of Male Beneficiaries | 1505 |
| Number Of Non Hispanic White Beneficiaries | 291 |
| Number Of Black or African American Beneficiaries | 33 |
| Number Of AsianPacific Islander Beneficiaries | 18 |
| Number Of Hispanic Beneficiaries | 1596 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 580 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1371 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 51 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.5762 |