| National Provider Identifier [NPI]: | 1447219415 |
| Last Name Of The Provider | MANOLACHE |
| First Name Of The Provider | PETRICA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4180 WARRENSVILLE CENTER RD |
| Street Address 2 Of The Provider | BUILDING A, SUITE 120 |
| City Of The Provider | BEACHWOOD |
| Zip Code Of The Provider | 441227024 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 29 |
| Number Of Services | 2801 |
| Number Of Medicare Beneficiaries | 601 |
| Total Submitted Charge Amount | 429568.82 |
| Total Medicare Allowed Amount | 285413.9 |
| Total Medicare Payment Amount | 219337.14 |
| Total Medicare Standardized Payment Amount | 223362.48 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 29 |
| Number Of Medical Services | 2801 |
| Number Of Medicare Beneficiaries With Medical Services | 601 |
| Total Medical Submitted Charge Amount | 429568.82 |
| Total Medical Medicare Allowed Amount | 285413.9 |
| Total Medical Medicare Payment Amount | 219337.14 |
| Total Medical Medicare Standardized Payment Amount | 223362.48 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 205 |
| Number Of Beneficiaries Age 65 to 74 | 126 |
| Number Of Beneficiaries Age 75 to 84 | 149 |
| Number Of Beneficiaries Age Greater 84 | 121 |
| Number Of Female Beneficiaries | 311 |
| Number Of Male Beneficiaries | 290 |
| Number Of Non Hispanic White Beneficiaries | 297 |
| Number Of Black or African American Beneficiaries | 288 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 301 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 300 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 35 |
| Percent Of With Asthma | 20 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 44 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 48 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 30 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 2.4363 |