National Provider Identifier [NPI]: |
1750386512 |
Last Name Of The Provider |
OLSON |
First Name Of The Provider |
JAMES |
Middle Initial Of The Provider |
N |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2825 E BARNETT RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
MEDFORD |
Zip Code Of The Provider |
975048332 |
State Code Of The Provider |
OR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pathology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
22 |
Number Of Services |
1545 |
Number Of Medicare Beneficiaries |
741 |
Total Submitted Charge Amount |
172680 |
Total Medicare Allowed Amount |
67235.68 |
Total Medicare Payment Amount |
50722.38 |
Total Medicare Standardized Payment Amount |
40178 |
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 |
22 |
Number Of Medical Services |
1545 |
Number Of Medicare Beneficiaries With Medical Services |
741 |
Total Medical Submitted Charge Amount |
172680 |
Total Medical Medicare Allowed Amount |
67235.68 |
Total Medical Medicare Payment Amount |
50722.38 |
Total Medical Medicare Standardized Payment Amount |
40178 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
103 |
Number Of Beneficiaries Age 65 to 74 |
373 |
Number Of Beneficiaries Age 75 to 84 |
192 |
Number Of Beneficiaries Age Greater 84 |
73 |
Number Of Female Beneficiaries |
390 |
Number Of Male Beneficiaries |
351 |
Number Of Non Hispanic White Beneficiaries |
713 |
Number Of Black or African American Beneficiaries |
0 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
13 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
610 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
131 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
2 |
Average HCC Risk Score Of Beneficiaries |
1.1034 |