| National Provider Identifier [NPI]: | 1851342539 |
| Last Name Of The Provider | CANAVAN |
| First Name Of The Provider | LYDIA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 10150 SORRENTO VALLEY RD |
| Street Address 2 Of The Provider | SUITE 320 |
| City Of The Provider | SAN DIEGO |
| Zip Code Of The Provider | 921211635 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 166 |
| Number Of Services | 9424 |
| Number Of Medicare Beneficiaries | 4771 |
| Total Submitted Charge Amount | 1002151.8 |
| Total Medicare Allowed Amount | 277911.89 |
| Total Medicare Payment Amount | 234896.87 |
| Total Medicare Standardized Payment Amount | 227676.33 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 1289 |
| Number Of Medicare Beneficiaries With Drug Services | 17 |
| Total Drug Submitted ChargeAmount | 1295 |
| Total Drug Medicare AllowedAmount | 277.1 |
| Total Drug Medicare PaymentAmount | 217.21 |
| Total Drug Medicare Standardized Payment Amount | 217.21 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 161 |
| Number Of Medical Services | 8135 |
| Number Of Medicare Beneficiaries With Medical Services | 4770 |
| Total Medical Submitted Charge Amount | 1000856.8 |
| Total Medical Medicare Allowed Amount | 277634.79 |
| Total Medical Medicare Payment Amount | 234679.66 |
| Total Medical Medicare Standardized Payment Amount | 227459.12 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 641 |
| Number Of Beneficiaries Age 65 to 74 | 2008 |
| Number Of Beneficiaries Age 75 to 84 | 1442 |
| Number Of Beneficiaries Age Greater 84 | 680 |
| Number Of Female Beneficiaries | 3648 |
| Number Of Male Beneficiaries | 1123 |
| Number Of Non Hispanic White Beneficiaries | 3119 |
| Number Of Black or African American Beneficiaries | 221 |
| Number Of AsianPacific Islander Beneficiaries | 283 |
| Number Of Hispanic Beneficiaries | 1005 |
| Number Of American Indian Alaska Native Beneficiaries | 74 |
| Number Of Beneficiaries With Race Not Else where Classified | 69 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3189 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1582 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.5253 |