| National Provider Identifier [NPI]: | 1508946914 |
| Last Name Of The Provider | OLSON |
| First Name Of The Provider | LUANN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 204 S MAIN |
| Street Address 2 Of The Provider | |
| City Of The Provider | ALEXIS |
| Zip Code Of The Provider | 61412 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 26 |
| Number Of Services | 393 |
| Number Of Medicare Beneficiaries | 219 |
| Total Submitted Charge Amount | 48533 |
| Total Medicare Allowed Amount | 19656.14 |
| Total Medicare Payment Amount | 13372.25 |
| Total Medicare Standardized Payment Amount | 17563.32 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 108 |
| Number Of Medicare Beneficiaries With Drug Services | 35 |
| Total Drug Submitted ChargeAmount | 818 |
| Total Drug Medicare AllowedAmount | 102.9 |
| Total Drug Medicare PaymentAmount | 56.01 |
| Total Drug Medicare Standardized Payment Amount | 56.01 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 21 |
| Number Of Medical Services | 285 |
| Number Of Medicare Beneficiaries With Medical Services | 219 |
| Total Medical Submitted Charge Amount | 47715 |
| Total Medical Medicare Allowed Amount | 19553.24 |
| Total Medical Medicare Payment Amount | 13316.24 |
| Total Medical Medicare Standardized Payment Amount | 17507.31 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 50 |
| Number Of Beneficiaries Age 65 to 74 | 91 |
| Number Of Beneficiaries Age 75 to 84 | 55 |
| Number Of Beneficiaries Age Greater 84 | 23 |
| Number Of Female Beneficiaries | 160 |
| Number Of Male Beneficiaries | 59 |
| Number Of Non Hispanic White Beneficiaries | 199 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| 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 | 167 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 52 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0109 |