| National Provider Identifier [NPI]: | 1275640765 |
| Last Name Of The Provider | MIHAILESCU |
| First Name Of The Provider | GABRIEL |
| 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 | 2845 GREENBRIER RD |
| Street Address 2 Of The Provider | #140 |
| City Of The Provider | GREEN BAY |
| Zip Code Of The Provider | 543088900 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 82 |
| Number Of Services | 4265 |
| Number Of Medicare Beneficiaries | 675 |
| Total Submitted Charge Amount | 565283.21 |
| Total Medicare Allowed Amount | 176143.96 |
| Total Medicare Payment Amount | 140105.45 |
| Total Medicare Standardized Payment Amount | 146847.71 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 448 |
| Number Of Medicare Beneficiaries With Drug Services | 281 |
| Total Drug Submitted ChargeAmount | 19832.21 |
| Total Drug Medicare AllowedAmount | 11626.39 |
| Total Drug Medicare PaymentAmount | 11183.06 |
| Total Drug Medicare Standardized Payment Amount | 11183.06 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 69 |
| Number Of Medical Services | 3817 |
| Number Of Medicare Beneficiaries With Medical Services | 674 |
| Total Medical Submitted Charge Amount | 545451 |
| Total Medical Medicare Allowed Amount | 164517.57 |
| Total Medical Medicare Payment Amount | 128922.39 |
| Total Medical Medicare Standardized Payment Amount | 135664.65 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 130 |
| Number Of Beneficiaries Age 65 to 74 | 287 |
| Number Of Beneficiaries Age 75 to 84 | 179 |
| Number Of Beneficiaries Age Greater 84 | 79 |
| Number Of Female Beneficiaries | 331 |
| Number Of Male Beneficiaries | 344 |
| Number Of Non Hispanic White Beneficiaries | 624 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 19 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 548 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 127 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2523 |