| National Provider Identifier [NPI]: | 1376798967 |
| Last Name Of The Provider | DOMBROW |
| First Name Of The Provider | MATTHEW |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2440 WHITNEY AVE |
| Street Address 2 Of The Provider | SUITE 103 |
| City Of The Provider | HAMDEN |
| Zip Code Of The Provider | 065183222 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 40 |
| Number Of Services | 2791 |
| Number Of Medicare Beneficiaries | 282 |
| Total Submitted Charge Amount | 1287104 |
| Total Medicare Allowed Amount | 597365.14 |
| Total Medicare Payment Amount | 461759.71 |
| Total Medicare Standardized Payment Amount | 451096.39 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 768 |
| Number Of Medicare Beneficiaries With Drug Services | 88 |
| Total Drug Submitted ChargeAmount | 508474 |
| Total Drug Medicare AllowedAmount | 375280.7 |
| Total Drug Medicare PaymentAmount | 294219.45 |
| Total Drug Medicare Standardized Payment Amount | 294219.45 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 31 |
| Number Of Medical Services | 2023 |
| Number Of Medicare Beneficiaries With Medical Services | 282 |
| Total Medical Submitted Charge Amount | 778630 |
| Total Medical Medicare Allowed Amount | 222084.44 |
| Total Medical Medicare Payment Amount | 167540.26 |
| Total Medical Medicare Standardized Payment Amount | 156876.94 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 19 |
| Number Of Beneficiaries Age 65 to 74 | 102 |
| Number Of Beneficiaries Age 75 to 84 | 89 |
| Number Of Beneficiaries Age Greater 84 | 72 |
| Number Of Female Beneficiaries | 174 |
| Number Of Male Beneficiaries | 108 |
| Number Of Non Hispanic White Beneficiaries | 237 |
| Number Of Black or African American Beneficiaries | 23 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 225 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 57 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.2756 |