| National Provider Identifier [NPI]: | 1720054927 |
| Last Name Of The Provider | CHAIPAT |
| First Name Of The Provider | LIDA |
| 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 | 170 |
| Number Of Services | 3669 |
| Number Of Medicare Beneficiaries | 2382 |
| Total Submitted Charge Amount | 335409 |
| Total Medicare Allowed Amount | 118075.01 |
| Total Medicare Payment Amount | 89092.02 |
| Total Medicare Standardized Payment Amount | 88742.71 |
| 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 | 170 |
| Number Of Medical Services | 3669 |
| Number Of Medicare Beneficiaries With Medical Services | 2382 |
| Total Medical Submitted Charge Amount | 335409 |
| Total Medical Medicare Allowed Amount | 118075.01 |
| Total Medical Medicare Payment Amount | 89092.02 |
| Total Medical Medicare Standardized Payment Amount | 88742.71 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 233 |
| Number Of Beneficiaries Age 65 to 74 | 870 |
| Number Of Beneficiaries Age 75 to 84 | 729 |
| Number Of Beneficiaries Age Greater 84 | 550 |
| Number Of Female Beneficiaries | 1579 |
| Number Of Male Beneficiaries | 803 |
| Number Of Non Hispanic White Beneficiaries | 1589 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 151 |
| Number Of Hispanic Beneficiaries | 506 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 67 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1695 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 687 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.7535 |