| National Provider Identifier [NPI]: | 1932155025 |
| Last Name Of The Provider | STAMBOLIU |
| First Name Of The Provider | HORIA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 326 W 64TH ST |
| Street Address 2 Of The Provider | SUITE 208 |
| City Of The Provider | CHICAGO |
| Zip Code Of The Provider | 606213114 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 5 |
| Number Of Services | 1147 |
| Number Of Medicare Beneficiaries | 277 |
| Total Submitted Charge Amount | 135150 |
| Total Medicare Allowed Amount | 98947.83 |
| Total Medicare Payment Amount | 77120.92 |
| Total Medicare Standardized Payment Amount | 72577.63 |
| 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 | 5 |
| Number Of Medical Services | 1147 |
| Number Of Medicare Beneficiaries With Medical Services | 277 |
| Total Medical Submitted Charge Amount | 135150 |
| Total Medical Medicare Allowed Amount | 98947.83 |
| Total Medical Medicare Payment Amount | 77120.92 |
| Total Medical Medicare Standardized Payment Amount | 72577.63 |
| Average Age Of Beneficiaries | 53 |
| Number Of Beneficiaries Age Less65 | 223 |
| Number Of Beneficiaries Age 65 to 74 | 32 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 92 |
| Number Of Male Beneficiaries | 185 |
| Number Of Non Hispanic White Beneficiaries | 52 |
| Number Of Black or African American Beneficiaries | 214 |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 0 |
| Number Of Beneficiaries With Medicare Only Entitlement | 15 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 262 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 27 |
| Percent Of With Asthma | 30 |
| Percent Of With Cancer | 5 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 47 |
| Percent Of With Depression | 75 |
| Percent Of With Diabetes | 52 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 61 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 75 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 2.2764 |