| National Provider Identifier [NPI]: | 1851561021 |
| Last Name Of The Provider | MCDIVIT |
| First Name Of The Provider | ANNA |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 709 AGATE ST |
| Street Address 2 Of The Provider | APT 6 |
| City Of The Provider | SAN DIEGO |
| Zip Code Of The Provider | 921091041 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 48 |
| Number Of Services | 2898 |
| Number Of Medicare Beneficiaries | 1623 |
| Total Submitted Charge Amount | 849993 |
| Total Medicare Allowed Amount | 159192.21 |
| Total Medicare Payment Amount | 120529.12 |
| Total Medicare Standardized Payment Amount | 119705.08 |
| 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 | 48 |
| Number Of Medical Services | 2898 |
| Number Of Medicare Beneficiaries With Medical Services | 1623 |
| Total Medical Submitted Charge Amount | 849993 |
| Total Medical Medicare Allowed Amount | 159192.21 |
| Total Medical Medicare Payment Amount | 120529.12 |
| Total Medical Medicare Standardized Payment Amount | 119705.08 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 416 |
| Number Of Beneficiaries Age 65 to 74 | 602 |
| Number Of Beneficiaries Age 75 to 84 | 404 |
| Number Of Beneficiaries Age Greater 84 | 201 |
| Number Of Female Beneficiaries | 733 |
| Number Of Male Beneficiaries | 890 |
| Number Of Non Hispanic White Beneficiaries | 946 |
| Number Of Black or African American Beneficiaries | 168 |
| Number Of AsianPacific Islander Beneficiaries | 114 |
| Number Of Hispanic Beneficiaries | 351 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 922 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 701 |
| Percent Of With Atrial Fibrillation | 24 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 49 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 59 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 2.6288 |