| National Provider Identifier [NPI]: | 1437263175 |
| Last Name Of The Provider | IANCU |
| First Name Of The Provider | MIHAI |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3417 ENSIGN ROAD NORTHEAST |
| Street Address 2 Of The Provider | |
| City Of The Provider | OLYMPIA |
| Zip Code Of The Provider | 985065075 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 205 |
| Number Of Services | 12861 |
| Number Of Medicare Beneficiaries | 4642 |
| Total Submitted Charge Amount | 736596.82 |
| Total Medicare Allowed Amount | 257953.2 |
| Total Medicare Payment Amount | 195864.41 |
| Total Medicare Standardized Payment Amount | 201480.95 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 5055 |
| Number Of Medicare Beneficiaries With Drug Services | 76 |
| Total Drug Submitted ChargeAmount | 9331.23 |
| Total Drug Medicare AllowedAmount | 882.12 |
| Total Drug Medicare PaymentAmount | 685.09 |
| Total Drug Medicare Standardized Payment Amount | 685.09 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 204 |
| Number Of Medical Services | 7806 |
| Number Of Medicare Beneficiaries With Medical Services | 4641 |
| Total Medical Submitted Charge Amount | 727265.59 |
| Total Medical Medicare Allowed Amount | 257071.08 |
| Total Medical Medicare Payment Amount | 195179.32 |
| Total Medical Medicare Standardized Payment Amount | 200795.86 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 814 |
| Number Of Beneficiaries Age 65 to 74 | 1653 |
| Number Of Beneficiaries Age 75 to 84 | 1360 |
| Number Of Beneficiaries Age Greater 84 | 815 |
| Number Of Female Beneficiaries | 2601 |
| Number Of Male Beneficiaries | 2041 |
| Number Of Non Hispanic White Beneficiaries | 4210 |
| Number Of Black or African American Beneficiaries | 53 |
| Number Of AsianPacific Islander Beneficiaries | 124 |
| Number Of Hispanic Beneficiaries | 102 |
| Number Of American Indian Alaska Native Beneficiaries | 90 |
| Number Of Beneficiaries With Race Not Else where Classified | 63 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3557 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1085 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.5799 |