| National Provider Identifier [NPI]: | 1679579247 |
| Last Name Of The Provider | KOLCUN |
| First Name Of The Provider | KEVIN |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | PA |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2200 NE NEFF RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | BEND |
| Zip Code Of The Provider | 977014283 |
| State Code Of The Provider | OR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 36 |
| Number Of Services | 3138 |
| Number Of Medicare Beneficiaries | 364 |
| Total Submitted Charge Amount | 411709.6 |
| Total Medicare Allowed Amount | 76136.93 |
| Total Medicare Payment Amount | 58124.88 |
| Total Medicare Standardized Payment Amount | 63150.49 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 2262 |
| Number Of Medicare Beneficiaries With Drug Services | 114 |
| Total Drug Submitted ChargeAmount | 34217.08 |
| Total Drug Medicare AllowedAmount | 24119.43 |
| Total Drug Medicare PaymentAmount | 18826.81 |
| Total Drug Medicare Standardized Payment Amount | 18826.81 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 32 |
| Number Of Medical Services | 876 |
| Number Of Medicare Beneficiaries With Medical Services | 364 |
| Total Medical Submitted Charge Amount | 377492.52 |
| Total Medical Medicare Allowed Amount | 52017.5 |
| Total Medical Medicare Payment Amount | 39298.07 |
| Total Medical Medicare Standardized Payment Amount | 44323.68 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 21 |
| Number Of Beneficiaries Age 65 to 74 | 207 |
| Number Of Beneficiaries Age 75 to 84 | 109 |
| Number Of Beneficiaries Age Greater 84 | 27 |
| Number Of Female Beneficiaries | 219 |
| Number Of Male Beneficiaries | 145 |
| Number Of Non Hispanic White Beneficiaries | 348 |
| Number Of Black or African American Beneficiaries | 0 |
| 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 | 343 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 21 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 3 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 16 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 57 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.8554 |