| National Provider Identifier [NPI]: | 1184723082 |
| Last Name Of The Provider | BRUNCK |
| First Name Of The Provider | BRIAN |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | P.A.-C. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 820 S MCCLELLAN ST |
| Street Address 2 Of The Provider | SUITE 300 |
| City Of The Provider | SPOKANE |
| Zip Code Of The Provider | 992042457 |
| 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 | 85 |
| Number Of Services | 553 |
| Number Of Medicare Beneficiaries | 150 |
| Total Submitted Charge Amount | 82695.28 |
| Total Medicare Allowed Amount | 27233.25 |
| Total Medicare Payment Amount | 20798.06 |
| Total Medicare Standardized Payment Amount | 23037.99 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 157 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 4489 |
| Total Drug Medicare AllowedAmount | 2159.89 |
| Total Drug Medicare PaymentAmount | 1685.11 |
| Total Drug Medicare Standardized Payment Amount | 1685.11 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 82 |
| Number Of Medical Services | 396 |
| Number Of Medicare Beneficiaries With Medical Services | 150 |
| Total Medical Submitted Charge Amount | 78206.28 |
| Total Medical Medicare Allowed Amount | 25073.36 |
| Total Medical Medicare Payment Amount | 19112.95 |
| Total Medical Medicare Standardized Payment Amount | 21352.88 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 37 |
| Number Of Beneficiaries Age 65 to 74 | 49 |
| Number Of Beneficiaries Age 75 to 84 | 40 |
| Number Of Beneficiaries Age Greater 84 | 24 |
| Number Of Female Beneficiaries | 90 |
| Number Of Male Beneficiaries | 60 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 108 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 42 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.6939 |