| National Provider Identifier [NPI]: | 1003894999 |
| Last Name Of The Provider | MCCALLIE |
| First Name Of The Provider | BRIAN |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 21601 76TH AVE W |
| Street Address 2 Of The Provider | STEVENS HOSPITAL |
| City Of The Provider | EDMONDS |
| Zip Code Of The Provider | 980267507 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 138 |
| Number Of Services | 20715 |
| Number Of Medicare Beneficiaries | 2224 |
| Total Submitted Charge Amount | 1235589.15 |
| Total Medicare Allowed Amount | 318119.04 |
| Total Medicare Payment Amount | 240461.74 |
| Total Medicare Standardized Payment Amount | 245662.56 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 17645 |
| Number Of Medicare Beneficiaries With Drug Services | 269 |
| Total Drug Submitted ChargeAmount | 7976.94 |
| Total Drug Medicare AllowedAmount | 6241.44 |
| Total Drug Medicare PaymentAmount | 4798.52 |
| Total Drug Medicare Standardized Payment Amount | 4798.52 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 134 |
| Number Of Medical Services | 3070 |
| Number Of Medicare Beneficiaries With Medical Services | 2224 |
| Total Medical Submitted Charge Amount | 1227612.21 |
| Total Medical Medicare Allowed Amount | 311877.6 |
| Total Medical Medicare Payment Amount | 235663.22 |
| Total Medical Medicare Standardized Payment Amount | 240864.04 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 297 |
| Number Of Beneficiaries Age 65 to 74 | 809 |
| Number Of Beneficiaries Age 75 to 84 | 737 |
| Number Of Beneficiaries Age Greater 84 | 381 |
| Number Of Female Beneficiaries | 1350 |
| Number Of Male Beneficiaries | 874 |
| Number Of Non Hispanic White Beneficiaries | 1859 |
| Number Of Black or African American Beneficiaries | 30 |
| Number Of AsianPacific Islander Beneficiaries | 211 |
| Number Of Hispanic Beneficiaries | 50 |
| Number Of American Indian Alaska Native Beneficiaries | 16 |
| Number Of Beneficiaries With Race Not Else where Classified | 58 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1650 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 574 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3729 |