| National Provider Identifier [NPI]: | 1245213164 |
| Last Name Of The Provider | OLSAN |
| First Name Of The Provider | ADAM |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1800 RYAN ST |
| Street Address 2 Of The Provider | SUITE 105 |
| City Of The Provider | LAKE CHARLES |
| Zip Code Of The Provider | 706016078 |
| State Code Of The Provider | LA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 208 |
| Number Of Services | 12084 |
| Number Of Medicare Beneficiaries | 5307 |
| Total Submitted Charge Amount | 1932590.75 |
| Total Medicare Allowed Amount | 379372.7 |
| Total Medicare Payment Amount | 282229.49 |
| Total Medicare Standardized Payment Amount | 305007.25 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 3569 |
| Number Of Medicare Beneficiaries With Drug Services | 141 |
| Total Drug Submitted ChargeAmount | 60591.75 |
| Total Drug Medicare AllowedAmount | 3786.62 |
| Total Drug Medicare PaymentAmount | 2953.34 |
| Total Drug Medicare Standardized Payment Amount | 2953.34 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 205 |
| Number Of Medical Services | 8515 |
| Number Of Medicare Beneficiaries With Medical Services | 5307 |
| Total Medical Submitted Charge Amount | 1871999 |
| Total Medical Medicare Allowed Amount | 375586.08 |
| Total Medical Medicare Payment Amount | 279276.15 |
| Total Medical Medicare Standardized Payment Amount | 302053.91 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 958 |
| Number Of Beneficiaries Age 65 to 74 | 2158 |
| Number Of Beneficiaries Age 75 to 84 | 1604 |
| Number Of Beneficiaries Age Greater 84 | 587 |
| Number Of Female Beneficiaries | 3238 |
| Number Of Male Beneficiaries | 2069 |
| Number Of Non Hispanic White Beneficiaries | 4294 |
| Number Of Black or African American Beneficiaries | 894 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 73 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 27 |
| Number Of Beneficiaries With Medicare Only Entitlement | 4116 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1191 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.4569 |