| National Provider Identifier [NPI]: | 1831206358 |
| Last Name Of The Provider | HUBACEK |
| First Name Of The Provider | LORI |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 201 N MAYFAIR RD |
| Street Address 2 Of The Provider | STE 515 |
| City Of The Provider | MILWAUKEE |
| Zip Code Of The Provider | 532264216 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 28 |
| Number Of Services | 692 |
| Number Of Medicare Beneficiaries | 148 |
| Total Submitted Charge Amount | 735625 |
| Total Medicare Allowed Amount | 69482.43 |
| Total Medicare Payment Amount | 52723.17 |
| Total Medicare Standardized Payment Amount | 55001.97 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 324 |
| Number Of Medicare Beneficiaries With Drug Services | 82 |
| Total Drug Submitted ChargeAmount | 97980 |
| Total Drug Medicare AllowedAmount | 42295.26 |
| Total Drug Medicare PaymentAmount | 32427.84 |
| Total Drug Medicare Standardized Payment Amount | 32427.84 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 26 |
| Number Of Medical Services | 368 |
| Number Of Medicare Beneficiaries With Medical Services | 148 |
| Total Medical Submitted Charge Amount | 637645 |
| Total Medical Medicare Allowed Amount | 27187.17 |
| Total Medical Medicare Payment Amount | 20295.33 |
| Total Medical Medicare Standardized Payment Amount | 22574.13 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 32 |
| Number Of Beneficiaries Age 65 to 74 | 49 |
| Number Of Beneficiaries Age 75 to 84 | 44 |
| Number Of Beneficiaries Age Greater 84 | 23 |
| Number Of Female Beneficiaries | 104 |
| Number Of Male Beneficiaries | 44 |
| Number Of Non Hispanic White Beneficiaries | 130 |
| 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 | 117 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 31 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0402 |