| National Provider Identifier [NPI]: | 1265407936 |
| Last Name Of The Provider | DULOWSKI |
| First Name Of The Provider | WOJCIECH |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1401 W LOCUST ST |
| Street Address 2 Of The Provider | STE. 102 |
| City Of The Provider | STILWELL |
| Zip Code Of The Provider | 749603217 |
| State Code Of The Provider | OK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 109 |
| Number Of Services | 9568 |
| Number Of Medicare Beneficiaries | 573 |
| Total Submitted Charge Amount | 671297 |
| Total Medicare Allowed Amount | 500406.72 |
| Total Medicare Payment Amount | 371022.9 |
| Total Medicare Standardized Payment Amount | 386880.45 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 20 |
| Number Of Drug Services | 1785 |
| Number Of Medicare Beneficiaries With Drug Services | 240 |
| Total Drug Submitted ChargeAmount | 28797.75 |
| Total Drug Medicare AllowedAmount | 12175.41 |
| Total Drug Medicare PaymentAmount | 9719.46 |
| Total Drug Medicare Standardized Payment Amount | 9719.46 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 89 |
| Number Of Medical Services | 7783 |
| Number Of Medicare Beneficiaries With Medical Services | 573 |
| Total Medical Submitted Charge Amount | 642499.25 |
| Total Medical Medicare Allowed Amount | 488231.31 |
| Total Medical Medicare Payment Amount | 361303.44 |
| Total Medical Medicare Standardized Payment Amount | 377160.99 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 209 |
| Number Of Beneficiaries Age 65 to 74 | 198 |
| Number Of Beneficiaries Age 75 to 84 | 116 |
| Number Of Beneficiaries Age Greater 84 | 50 |
| Number Of Female Beneficiaries | 343 |
| Number Of Male Beneficiaries | 230 |
| Number Of Non Hispanic White Beneficiaries | 371 |
| Number Of Black or African American Beneficiaries | 0 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 190 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 236 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 337 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 48 |
| Percent Of With Depression | 42 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 66 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.7601 |