| National Provider Identifier [NPI]: | 1386691251 |
| Last Name Of The Provider | JULIEN |
| First Name Of The Provider | KATIE |
| 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 | 1868 W 9800 S |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | SOUTH JORDAN |
| Zip Code Of The Provider | 840954713 |
| State Code Of The Provider | UT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 34 |
| Number Of Services | 420 |
| Number Of Medicare Beneficiaries | 94 |
| Total Submitted Charge Amount | 36870.83 |
| Total Medicare Allowed Amount | 24824.84 |
| Total Medicare Payment Amount | 17953.94 |
| Total Medicare Standardized Payment Amount | 18973.79 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 80 |
| Number Of Medicare Beneficiaries With Drug Services | 48 |
| Total Drug Submitted ChargeAmount | 3752 |
| Total Drug Medicare AllowedAmount | 2403.87 |
| Total Drug Medicare PaymentAmount | 2316.43 |
| Total Drug Medicare Standardized Payment Amount | 2316.43 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 27 |
| Number Of Medical Services | 340 |
| Number Of Medicare Beneficiaries With Medical Services | 94 |
| Total Medical Submitted Charge Amount | 33118.83 |
| Total Medical Medicare Allowed Amount | 22420.97 |
| Total Medical Medicare Payment Amount | 15637.51 |
| Total Medical Medicare Standardized Payment Amount | 16657.36 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 56 |
| Number Of Beneficiaries Age 75 to 84 | 18 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 66 |
| Number Of Male Beneficiaries | 28 |
| 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 | 83 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 11 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 32 |
| Percent Of With Hypertension | 33 |
| Percent Of With Ischemic Heart Disease | 18 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 26 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7266 |