| National Provider Identifier [NPI]: | 1801087374 |
| Last Name Of The Provider | TOMINNA |
| First Name Of The Provider | BRANDON |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4201 SAINT ANTOINE ST # 3L-8 |
| Street Address 2 Of The Provider | |
| City Of The Provider | DETROIT |
| Zip Code Of The Provider | 482012153 |
| 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 | 241 |
| Number Of Services | 3934 |
| Number Of Medicare Beneficiaries | 2246 |
| Total Submitted Charge Amount | 511262.5 |
| Total Medicare Allowed Amount | 182309.3 |
| Total Medicare Payment Amount | 132455.18 |
| Total Medicare Standardized Payment Amount | 136117.12 |
| 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 | 241 |
| Number Of Medical Services | 3934 |
| Number Of Medicare Beneficiaries With Medical Services | 2246 |
| Total Medical Submitted Charge Amount | 511262.5 |
| Total Medical Medicare Allowed Amount | 182309.3 |
| Total Medical Medicare Payment Amount | 132455.18 |
| Total Medical Medicare Standardized Payment Amount | 136117.12 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 537 |
| Number Of Beneficiaries Age 65 to 74 | 806 |
| Number Of Beneficiaries Age 75 to 84 | 604 |
| Number Of Beneficiaries Age Greater 84 | 299 |
| Number Of Female Beneficiaries | 1229 |
| Number Of Male Beneficiaries | 1017 |
| Number Of Non Hispanic White Beneficiaries | 2034 |
| Number Of Black or African American Beneficiaries | 155 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 25 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1595 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 651 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 36 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 56 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.8576 |