| National Provider Identifier [NPI]: | 1164503314 |
| Last Name Of The Provider | MCCOLLUM |
| First Name Of The Provider | BRYNA |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 13231 SE 36TH ST STE 110 |
| Street Address 2 Of The Provider | |
| City Of The Provider | BELLEVUE |
| Zip Code Of The Provider | 980067321 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 34 |
| Number Of Services | 303 |
| Number Of Medicare Beneficiaries | 117 |
| Total Submitted Charge Amount | 35645.62 |
| Total Medicare Allowed Amount | 16442.02 |
| Total Medicare Payment Amount | 11440.3 |
| Total Medicare Standardized Payment Amount | 12717.14 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 43 |
| Number Of Medicare Beneficiaries With Drug Services | 27 |
| Total Drug Submitted ChargeAmount | 1132.1 |
| Total Drug Medicare AllowedAmount | 896.18 |
| Total Drug Medicare PaymentAmount | 876.97 |
| Total Drug Medicare Standardized Payment Amount | 876.97 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 29 |
| Number Of Medical Services | 260 |
| Number Of Medicare Beneficiaries With Medical Services | 117 |
| Total Medical Submitted Charge Amount | 34513.52 |
| Total Medical Medicare Allowed Amount | 15545.84 |
| Total Medical Medicare Payment Amount | 10563.33 |
| Total Medical Medicare Standardized Payment Amount | 11840.17 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 39 |
| Number Of Beneficiaries Age 65 to 74 | 40 |
| Number Of Beneficiaries Age 75 to 84 | 18 |
| Number Of Beneficiaries Age Greater 84 | 20 |
| Number Of Female Beneficiaries | 63 |
| Number Of Male Beneficiaries | 54 |
| Number Of Non Hispanic White Beneficiaries | 85 |
| Number Of Black or African American Beneficiaries | 11 |
| 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 | 63 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 54 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 18 |
| Percent Of With Hyperlipidemia | 25 |
| Percent Of With Hypertension | 45 |
| Percent Of With Ischemic Heart Disease | 16 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 21 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0249 |