| National Provider Identifier [NPI]: | 1003819301 |
| Last Name Of The Provider | POULSEN |
| First Name Of The Provider | ERIC |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1360 E HERNDON AVE |
| Street Address 2 Of The Provider | STE 201 |
| City Of The Provider | FRESNO |
| Zip Code Of The Provider | 937203326 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 64 |
| Number Of Services | 4081 |
| Number Of Medicare Beneficiaries | 1609 |
| Total Submitted Charge Amount | 1505537 |
| Total Medicare Allowed Amount | 642268.2 |
| Total Medicare Payment Amount | 471264.45 |
| Total Medicare Standardized Payment Amount | 452356.25 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
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| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 129 |
| Number Of Beneficiaries Age 65 to 74 | 653 |
| Number Of Beneficiaries Age 75 to 84 | 562 |
| Number Of Beneficiaries Age Greater 84 | 265 |
| Number Of Female Beneficiaries | 1005 |
| Number Of Male Beneficiaries | 604 |
| Number Of Non Hispanic White Beneficiaries | 1079 |
| Number Of Black or African American Beneficiaries | 46 |
| Number Of AsianPacific Islander Beneficiaries | 147 |
| Number Of Hispanic Beneficiaries | 283 |
| Number Of American Indian Alaska Native Beneficiaries | 37 |
| Number Of Beneficiaries With Race Not Else where Classified | 17 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1167 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 442 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1348 |