| National Provider Identifier [NPI]: | 1285685925 |
| Last Name Of The Provider | O'SHAUGHNESSY |
| First Name Of The Provider | LOUISE |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 501 WASHINGTON ST |
| Street Address 2 Of The Provider | STE 510 |
| City Of The Provider | SAN DIEGO |
| Zip Code Of The Provider | 921032231 |
| 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 | 124 |
| Number Of Services | 4708 |
| Number Of Medicare Beneficiaries | 2380 |
| Total Submitted Charge Amount | 920873.28 |
| Total Medicare Allowed Amount | 260311.41 |
| Total Medicare Payment Amount | 203314.32 |
| Total Medicare Standardized Payment Amount | 192751.82 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 712 |
| Number Of Medicare Beneficiaries With Drug Services | 32 |
| Total Drug Submitted ChargeAmount | 8044 |
| Total Drug Medicare AllowedAmount | 847.24 |
| Total Drug Medicare PaymentAmount | 642.12 |
| Total Drug Medicare Standardized Payment Amount | 642.12 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 120 |
| Number Of Medical Services | 3996 |
| Number Of Medicare Beneficiaries With Medical Services | 2380 |
| Total Medical Submitted Charge Amount | 912829.28 |
| Total Medical Medicare Allowed Amount | 259464.17 |
| Total Medical Medicare Payment Amount | 202672.2 |
| Total Medical Medicare Standardized Payment Amount | 192109.7 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 441 |
| Number Of Beneficiaries Age 65 to 74 | 999 |
| Number Of Beneficiaries Age 75 to 84 | 678 |
| Number Of Beneficiaries Age Greater 84 | 262 |
| Number Of Female Beneficiaries | 1634 |
| Number Of Male Beneficiaries | 746 |
| Number Of Non Hispanic White Beneficiaries | 1403 |
| Number Of Black or African American Beneficiaries | 176 |
| Number Of AsianPacific Islander Beneficiaries | 231 |
| Number Of Hispanic Beneficiaries | 503 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1260 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1120 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.4584 |