| National Provider Identifier [NPI]: | 1639149651 |
| Last Name Of The Provider | OLSON |
| First Name Of The Provider | ERIC |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 322 BEARD CREEK RD |
| Street Address 2 Of The Provider | SUITE 200 C/O LISA KERSTIENS CREDENTIALING |
| City Of The Provider | EDWARDS |
| Zip Code Of The Provider | 81632 |
| State Code Of The Provider | CO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 66 |
| Number Of Services | 522 |
| Number Of Medicare Beneficiaries | 242 |
| Total Submitted Charge Amount | 92063.39 |
| Total Medicare Allowed Amount | 28857.53 |
| Total Medicare Payment Amount | 23289.14 |
| Total Medicare Standardized Payment Amount | 23609.12 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 34 |
| Number Of Medicare Beneficiaries With Drug Services | 24 |
| Total Drug Submitted ChargeAmount | 1406 |
| Total Drug Medicare AllowedAmount | 1258.53 |
| Total Drug Medicare PaymentAmount | 1228.51 |
| Total Drug Medicare Standardized Payment Amount | 1228.51 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 57 |
| Number Of Medical Services | 488 |
| Number Of Medicare Beneficiaries With Medical Services | 242 |
| Total Medical Submitted Charge Amount | 90657.39 |
| Total Medical Medicare Allowed Amount | 27599 |
| Total Medical Medicare Payment Amount | 22060.63 |
| Total Medical Medicare Standardized Payment Amount | 22380.61 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 166 |
| Number Of Beneficiaries Age 75 to 84 | 55 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 164 |
| Number Of Male Beneficiaries | 78 |
| Number Of Non Hispanic White Beneficiaries | 226 |
| Number Of Black or African American Beneficiaries | 0 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 6 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 8 |
| Percent Of With Hyperlipidemia | 36 |
| Percent Of With Hypertension | 34 |
| Percent Of With Ischemic Heart Disease | 10 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.6278 |