| National Provider Identifier [NPI]: | 1770605271 |
| Last Name Of The Provider | OLSEN |
| First Name Of The Provider | STEPHEN |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1500 E MEDICAL CENTER DR |
| Street Address 2 Of The Provider | 2ND FLOOR UNIVERSITY HOSPITAL RECP PATHOLOGY |
| City Of The Provider | ANN ARBOR |
| Zip Code Of The Provider | 481090999 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 8 |
| Number Of Services | 7671 |
| Number Of Medicare Beneficiaries | 4612 |
| Total Submitted Charge Amount | 485410 |
| Total Medicare Allowed Amount | 352257.34 |
| Total Medicare Payment Amount | 259168.18 |
| Total Medicare Standardized Payment Amount | 212690.73 |
| 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 | 8 |
| Number Of Medical Services | 7671 |
| Number Of Medicare Beneficiaries With Medical Services | 4612 |
| Total Medical Submitted Charge Amount | 485410 |
| Total Medical Medicare Allowed Amount | 352257.34 |
| Total Medical Medicare Payment Amount | 259168.18 |
| Total Medical Medicare Standardized Payment Amount | 212690.73 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 283 |
| Number Of Beneficiaries Age 65 to 74 | 1921 |
| Number Of Beneficiaries Age 75 to 84 | 1565 |
| Number Of Beneficiaries Age Greater 84 | 843 |
| Number Of Female Beneficiaries | 2337 |
| Number Of Male Beneficiaries | 2275 |
| Number Of Non Hispanic White Beneficiaries | 4378 |
| Number Of Black or African American Beneficiaries | 101 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 41 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 69 |
| Number Of Beneficiaries With Medicare Only Entitlement | 4325 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 287 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1238 |