| National Provider Identifier [NPI]: | 1053501452 |
| Last Name Of The Provider | NICOLESCU |
| First Name Of The Provider | IOAN |
| Middle Initial Of The Provider | V |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1600 N GRAND AVE STE 245 |
| Street Address 2 Of The Provider | |
| City Of The Provider | PUEBLO |
| Zip Code Of The Provider | 810032731 |
| State Code Of The Provider | CO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 39 |
| Number Of Services | 1750 |
| Number Of Medicare Beneficiaries | 469 |
| Total Submitted Charge Amount | 353535.07 |
| Total Medicare Allowed Amount | 145378.52 |
| Total Medicare Payment Amount | 105171.92 |
| Total Medicare Standardized Payment Amount | 105560.29 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 174 |
| Number Of Medicare Beneficiaries With Drug Services | 130 |
| Total Drug Submitted ChargeAmount | 9012.47 |
| Total Drug Medicare AllowedAmount | 4239.73 |
| Total Drug Medicare PaymentAmount | 4089.74 |
| Total Drug Medicare Standardized Payment Amount | 4089.74 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 32 |
| Number Of Medical Services | 1576 |
| Number Of Medicare Beneficiaries With Medical Services | 469 |
| Total Medical Submitted Charge Amount | 344522.6 |
| Total Medical Medicare Allowed Amount | 141138.79 |
| Total Medical Medicare Payment Amount | 101082.18 |
| Total Medical Medicare Standardized Payment Amount | 101470.55 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 98 |
| Number Of Beneficiaries Age 65 to 74 | 137 |
| Number Of Beneficiaries Age 75 to 84 | 137 |
| Number Of Beneficiaries Age Greater 84 | 97 |
| Number Of Female Beneficiaries | 257 |
| Number Of Male Beneficiaries | 212 |
| Number Of Non Hispanic White Beneficiaries | 350 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 108 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 338 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 131 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3804 |