| National Provider Identifier [NPI]: | 1538334081 |
| Last Name Of The Provider | FARIAS |
| First Name Of The Provider | JULIE |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6600 EXCELSIOR BLVD |
| Street Address 2 Of The Provider | SUITE 160 |
| City Of The Provider | SAINT LOUIS PARK |
| Zip Code Of The Provider | 554264744 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 58 |
| Number Of Services | 477 |
| Number Of Medicare Beneficiaries | 96 |
| Total Submitted Charge Amount | 42754.3 |
| Total Medicare Allowed Amount | 18975.54 |
| Total Medicare Payment Amount | 14198.7 |
| Total Medicare Standardized Payment Amount | 14531.45 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 20 |
| Number Of Medicare Beneficiaries With Drug Services | 16 |
| Total Drug Submitted ChargeAmount | 1040 |
| Total Drug Medicare AllowedAmount | 684.39 |
| Total Drug Medicare PaymentAmount | 669.32 |
| Total Drug Medicare Standardized Payment Amount | 669.32 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 52 |
| Number Of Medical Services | 457 |
| Number Of Medicare Beneficiaries With Medical Services | 96 |
| Total Medical Submitted Charge Amount | 41714.3 |
| Total Medical Medicare Allowed Amount | 18291.15 |
| Total Medical Medicare Payment Amount | 13529.38 |
| Total Medical Medicare Standardized Payment Amount | 13862.13 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 38 |
| Number Of Beneficiaries Age 65 to 74 | 25 |
| Number Of Beneficiaries Age 75 to 84 | 19 |
| Number Of Beneficiaries Age Greater 84 | 14 |
| Number Of Female Beneficiaries | 72 |
| Number Of Male Beneficiaries | 24 |
| Number Of Non Hispanic White Beneficiaries | 77 |
| 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 | 58 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 38 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 50 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 38 |
| Percent Of With Hypertension | 52 |
| Percent Of With Ischemic Heart Disease | 15 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 14 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.4212 |