| National Provider Identifier [NPI]: | 1609808187 |
| Last Name Of The Provider | TAFARA |
| First Name Of The Provider | FACIKA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 823 GATEWAY CENTER WAY |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAN DIEGO |
| Zip Code Of The Provider | 921024541 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 130 |
| Number Of Services | 16708 |
| Number Of Medicare Beneficiaries | 2623 |
| Total Submitted Charge Amount | 359584.65 |
| Total Medicare Allowed Amount | 226310.17 |
| Total Medicare Payment Amount | 218285.41 |
| Total Medicare Standardized Payment Amount | 218976.14 |
| 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 | 130 |
| Number Of Medical Services | 16708 |
| Number Of Medicare Beneficiaries With Medical Services | 2623 |
| Total Medical Submitted Charge Amount | 359584.65 |
| Total Medical Medicare Allowed Amount | 226310.17 |
| Total Medical Medicare Payment Amount | 218285.41 |
| Total Medical Medicare Standardized Payment Amount | 218976.14 |
| Average Age Of Beneficiaries | 62 |
| Number Of Beneficiaries Age Less65 | 1173 |
| Number Of Beneficiaries Age 65 to 74 | 1095 |
| Number Of Beneficiaries Age 75 to 84 | 280 |
| Number Of Beneficiaries Age Greater 84 | 75 |
| Number Of Female Beneficiaries | 1309 |
| Number Of Male Beneficiaries | 1314 |
| Number Of Non Hispanic White Beneficiaries | 892 |
| Number Of Black or African American Beneficiaries | 322 |
| Number Of AsianPacific Islander Beneficiaries | 155 |
| Number Of Hispanic Beneficiaries | 1185 |
| Number Of American Indian Alaska Native Beneficiaries | 13 |
| Number Of Beneficiaries With Race Not Else where Classified | 56 |
| Number Of Beneficiaries With Medicare Only Entitlement | 445 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 2178 |
| Percent Of With Atrial Fibrillation | 3 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 4 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 21 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 24 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.1896 |