| National Provider Identifier [NPI]: | 1154329126 |
| Last Name Of The Provider | DOMBROWSKI |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3301 NEW MEXICO AVE NW |
| Street Address 2 Of The Provider | SUITE 346 |
| City Of The Provider | WASHINGTON |
| Zip Code Of The Provider | 200163622 |
| State Code Of The Provider | DC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Interventional Pain Management |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 80 |
| Number Of Services | 4601 |
| Number Of Medicare Beneficiaries | 446 |
| Total Submitted Charge Amount | 1404573 |
| Total Medicare Allowed Amount | 371569.27 |
| Total Medicare Payment Amount | 287311.82 |
| Total Medicare Standardized Payment Amount | 245947.04 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 2939 |
| Number Of Medicare Beneficiaries With Drug Services | 283 |
| Total Drug Submitted ChargeAmount | 87770 |
| Total Drug Medicare AllowedAmount | 5202.59 |
| Total Drug Medicare PaymentAmount | 4000.28 |
| Total Drug Medicare Standardized Payment Amount | 4000.28 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 76 |
| Number Of Medical Services | 1662 |
| Number Of Medicare Beneficiaries With Medical Services | 446 |
| Total Medical Submitted Charge Amount | 1316803 |
| Total Medical Medicare Allowed Amount | 366366.68 |
| Total Medical Medicare Payment Amount | 283311.54 |
| Total Medical Medicare Standardized Payment Amount | 241946.76 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 60 |
| Number Of Beneficiaries Age 65 to 74 | 179 |
| Number Of Beneficiaries Age 75 to 84 | 136 |
| Number Of Beneficiaries Age Greater 84 | 71 |
| Number Of Female Beneficiaries | 277 |
| Number Of Male Beneficiaries | 169 |
| Number Of Non Hispanic White Beneficiaries | 285 |
| Number Of Black or African American Beneficiaries | 135 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 12 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 370 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 76 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 65 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.7254 |