| National Provider Identifier [NPI]: | 1497753560 |
| Last Name Of The Provider | POULOSE |
| First Name Of The Provider | ABRAHAM |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4321 WASHINGTON ST |
| Street Address 2 Of The Provider | SUITE 2100 |
| City Of The Provider | KANSAS CITY |
| Zip Code Of The Provider | 641115961 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 46 |
| Number Of Services | 8970 |
| Number Of Medicare Beneficiaries | 1625 |
| Total Submitted Charge Amount | 2597531 |
| Total Medicare Allowed Amount | 1447324.2 |
| Total Medicare Payment Amount | 1091993.53 |
| Total Medicare Standardized Payment Amount | 1126859.67 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 1976 |
| Number Of Medicare Beneficiaries With Drug Services | 80 |
| Total Drug Submitted ChargeAmount | 1097710 |
| Total Drug Medicare AllowedAmount | 661411.78 |
| Total Drug Medicare PaymentAmount | 516505.84 |
| Total Drug Medicare Standardized Payment Amount | 516505.84 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 42 |
| Number Of Medical Services | 6994 |
| Number Of Medicare Beneficiaries With Medical Services | 1625 |
| Total Medical Submitted Charge Amount | 1499821 |
| Total Medical Medicare Allowed Amount | 785912.42 |
| Total Medical Medicare Payment Amount | 575487.69 |
| Total Medical Medicare Standardized Payment Amount | 610353.83 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 171 |
| Number Of Beneficiaries Age 65 to 74 | 621 |
| Number Of Beneficiaries Age 75 to 84 | 528 |
| Number Of Beneficiaries Age Greater 84 | 305 |
| Number Of Female Beneficiaries | 997 |
| Number Of Male Beneficiaries | 628 |
| Number Of Non Hispanic White Beneficiaries | 1356 |
| Number Of Black or African American Beneficiaries | 182 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 50 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 19 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1412 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 213 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3845 |