| National Provider Identifier [NPI]: | 1871537191 |
| Last Name Of The Provider | OJEDA-FOURNIER |
| First Name Of The Provider | HAYDEE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3855 HEALTH SCIENCES DRIVE |
| Street Address 2 Of The Provider | MC0846 |
| City Of The Provider | LA JOLLA |
| Zip Code Of The Provider | 920930846 |
| 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 | 53 |
| Number Of Services | 2756 |
| Number Of Medicare Beneficiaries | 1709 |
| Total Submitted Charge Amount | 715946 |
| Total Medicare Allowed Amount | 121293.34 |
| Total Medicare Payment Amount | 102831.43 |
| Total Medicare Standardized Payment Amount | 100318.48 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 623 |
| Number Of Medicare Beneficiaries With Drug Services | 30 |
| Total Drug Submitted ChargeAmount | 4984 |
| Total Drug Medicare AllowedAmount | 1231.87 |
| Total Drug Medicare PaymentAmount | 965.89 |
| Total Drug Medicare Standardized Payment Amount | 965.89 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 52 |
| Number Of Medical Services | 2133 |
| Number Of Medicare Beneficiaries With Medical Services | 1709 |
| Total Medical Submitted Charge Amount | 710962 |
| Total Medical Medicare Allowed Amount | 120061.47 |
| Total Medical Medicare Payment Amount | 101865.54 |
| Total Medical Medicare Standardized Payment Amount | 99352.59 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 198 |
| Number Of Beneficiaries Age 65 to 74 | 975 |
| Number Of Beneficiaries Age 75 to 84 | 424 |
| Number Of Beneficiaries Age Greater 84 | 112 |
| Number Of Female Beneficiaries | 1638 |
| Number Of Male Beneficiaries | 71 |
| Number Of Non Hispanic White Beneficiaries | 1249 |
| Number Of Black or African American Beneficiaries | 91 |
| Number Of AsianPacific Islander Beneficiaries | 146 |
| Number Of Hispanic Beneficiaries | 162 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1359 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 350 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 39 |
| Percent Of With Hypertension | 48 |
| Percent Of With Ischemic Heart Disease | 17 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0034 |