| National Provider Identifier [NPI]: | 1346267036 |
| Last Name Of The Provider | ULLOA-MICHAELIS |
| First Name Of The Provider | JULIE |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 820 S. MCCLELLAN ST |
| Street Address 2 Of The Provider | STE 200 |
| City Of The Provider | SPOKANE |
| Zip Code Of The Provider | 992042456 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 90 |
| Number Of Services | 2077 |
| Number Of Medicare Beneficiaries | 207 |
| Total Submitted Charge Amount | 186801 |
| Total Medicare Allowed Amount | 81493.81 |
| Total Medicare Payment Amount | 67035.39 |
| Total Medicare Standardized Payment Amount | 67625.08 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 73 |
| Number Of Medicare Beneficiaries With Drug Services | 58 |
| Total Drug Submitted ChargeAmount | 4862 |
| Total Drug Medicare AllowedAmount | 2685.59 |
| Total Drug Medicare PaymentAmount | 2254.4 |
| Total Drug Medicare Standardized Payment Amount | 2254.4 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 83 |
| Number Of Medical Services | 2004 |
| Number Of Medicare Beneficiaries With Medical Services | 206 |
| Total Medical Submitted Charge Amount | 181939 |
| Total Medical Medicare Allowed Amount | 78808.22 |
| Total Medical Medicare Payment Amount | 64780.99 |
| Total Medical Medicare Standardized Payment Amount | 65370.68 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 81 |
| Number Of Beneficiaries Age 75 to 84 | 80 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 161 |
| Number Of Male Beneficiaries | 46 |
| 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 | 194 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 13 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 17 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 50 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0314 |