| National Provider Identifier [NPI]: | 1992907026 |
| Last Name Of The Provider | DOMBROWSKI |
| First Name Of The Provider | ALEX |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | OAKWOOD HOSPITAL MEDICAL CENTER |
| Street Address 2 Of The Provider | 18101 OAKWOOD BLVD. |
| City Of The Provider | DEARBORN |
| Zip Code Of The Provider | 48124 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 188 |
| Number Of Services | 4394 |
| Number Of Medicare Beneficiaries | 3006 |
| Total Submitted Charge Amount | 676119 |
| Total Medicare Allowed Amount | 200624.77 |
| Total Medicare Payment Amount | 151241.28 |
| Total Medicare Standardized Payment Amount | 157157.87 |
| 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 | 188 |
| Number Of Medical Services | 4394 |
| Number Of Medicare Beneficiaries With Medical Services | 3006 |
| Total Medical Submitted Charge Amount | 676119 |
| Total Medical Medicare Allowed Amount | 200624.77 |
| Total Medical Medicare Payment Amount | 151241.28 |
| Total Medical Medicare Standardized Payment Amount | 157157.87 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 674 |
| Number Of Beneficiaries Age 65 to 74 | 1084 |
| Number Of Beneficiaries Age 75 to 84 | 844 |
| Number Of Beneficiaries Age Greater 84 | 404 |
| Number Of Female Beneficiaries | 1699 |
| Number Of Male Beneficiaries | 1307 |
| Number Of Non Hispanic White Beneficiaries | 2904 |
| Number Of Black or African American Beneficiaries | 20 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 36 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 32 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2197 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 809 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.4959 |