| National Provider Identifier [NPI]: | 1487703922 |
| Last Name Of The Provider | OLSON |
| First Name Of The Provider | JON |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 21701 76TH AVE W |
| Street Address 2 Of The Provider | #203 |
| City Of The Provider | EDMONDS |
| Zip Code Of The Provider | 980267536 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pain Management |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 21 |
| Number Of Services | 773 |
| Number Of Medicare Beneficiaries | 211 |
| Total Submitted Charge Amount | 145777 |
| Total Medicare Allowed Amount | 67414.73 |
| Total Medicare Payment Amount | 46817.68 |
| Total Medicare Standardized Payment Amount | 49963.45 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 58 |
| Number Of Medicare Beneficiaries With Drug Services | 29 |
| Total Drug Submitted ChargeAmount | 537 |
| Total Drug Medicare AllowedAmount | 230.68 |
| Total Drug Medicare PaymentAmount | 174.31 |
| Total Drug Medicare Standardized Payment Amount | 174.31 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 19 |
| Number Of Medical Services | 715 |
| Number Of Medicare Beneficiaries With Medical Services | 211 |
| Total Medical Submitted Charge Amount | 145240 |
| Total Medical Medicare Allowed Amount | 67184.05 |
| Total Medical Medicare Payment Amount | 46643.37 |
| Total Medical Medicare Standardized Payment Amount | 49789.14 |
| Average Age Of Beneficiaries | 61 |
| Number Of Beneficiaries Age Less65 | 122 |
| Number Of Beneficiaries Age 65 to 74 | 67 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 135 |
| Number Of Male Beneficiaries | 76 |
| Number Of Non Hispanic White Beneficiaries | 193 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 154 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 57 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 27 |
| Percent Of With Hypertension | 38 |
| Percent Of With Ischemic Heart Disease | 15 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.075 |