| National Provider Identifier [NPI]: | 1144431354 |
| Last Name Of The Provider | PROHASKA |
| First Name Of The Provider | JULIA |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | PA |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4402 CHURCHMAN AVE |
| Street Address 2 Of The Provider | SUITE 300 |
| City Of The Provider | LOUISVILLE |
| Zip Code Of The Provider | 402151190 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 44 |
| Number Of Services | 1407 |
| Number Of Medicare Beneficiaries | 158 |
| Total Submitted Charge Amount | 75657 |
| Total Medicare Allowed Amount | 34535.45 |
| Total Medicare Payment Amount | 25773.68 |
| Total Medicare Standardized Payment Amount | 30560.69 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 859 |
| Number Of Medicare Beneficiaries With Drug Services | 24 |
| Total Drug Submitted ChargeAmount | 20581 |
| Total Drug Medicare AllowedAmount | 10714.7 |
| Total Drug Medicare PaymentAmount | 8400.36 |
| Total Drug Medicare Standardized Payment Amount | 8400.36 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 40 |
| Number Of Medical Services | 548 |
| Number Of Medicare Beneficiaries With Medical Services | 158 |
| Total Medical Submitted Charge Amount | 55076 |
| Total Medical Medicare Allowed Amount | 23820.75 |
| Total Medical Medicare Payment Amount | 17373.32 |
| Total Medical Medicare Standardized Payment Amount | 22160.33 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 66 |
| Number Of Beneficiaries Age 65 to 74 | 43 |
| Number Of Beneficiaries Age 75 to 84 | 29 |
| Number Of Beneficiaries Age Greater 84 | 20 |
| Number Of Female Beneficiaries | 104 |
| Number Of Male Beneficiaries | 54 |
| Number Of Non Hispanic White Beneficiaries | 140 |
| 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 | 98 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 60 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 59 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.7206 |