| National Provider Identifier [NPI]: | 1033373287 |
| Last Name Of The Provider | OSPINA |
| First Name Of The Provider | JOSE |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD, PHD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1509 WILSON TER |
| Street Address 2 Of The Provider | |
| City Of The Provider | GLENDALE |
| Zip Code Of The Provider | 912064007 |
| 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 | 153 |
| Number Of Services | 4958 |
| Number Of Medicare Beneficiaries | 2792 |
| Total Submitted Charge Amount | 609676 |
| Total Medicare Allowed Amount | 156271.83 |
| Total Medicare Payment Amount | 116391.27 |
| Total Medicare Standardized Payment Amount | 111152.1 |
| 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 | 153 |
| Number Of Medical Services | 4958 |
| Number Of Medicare Beneficiaries With Medical Services | 2792 |
| Total Medical Submitted Charge Amount | 609676 |
| Total Medical Medicare Allowed Amount | 156271.83 |
| Total Medical Medicare Payment Amount | 116391.27 |
| Total Medical Medicare Standardized Payment Amount | 111152.1 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 709 |
| Number Of Beneficiaries Age 65 to 74 | 856 |
| Number Of Beneficiaries Age 75 to 84 | 724 |
| Number Of Beneficiaries Age Greater 84 | 503 |
| Number Of Female Beneficiaries | 1559 |
| Number Of Male Beneficiaries | 1233 |
| Number Of Non Hispanic White Beneficiaries | 812 |
| Number Of Black or African American Beneficiaries | 618 |
| Number Of AsianPacific Islander Beneficiaries | 156 |
| Number Of Hispanic Beneficiaries | 1058 |
| Number Of American Indian Alaska Native Beneficiaries | 108 |
| Number Of Beneficiaries With Race Not Else where Classified | 40 |
| Number Of Beneficiaries With Medicare Only Entitlement | 748 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 2044 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 35 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 50 |
| Percent Of With Chronic Kidney Disease | 46 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 37 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 59 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 61 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 20 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 2.7072 |