| National Provider Identifier [NPI]: | 1740271451 |
| Last Name Of The Provider | CAMPANINI |
| First Name Of The Provider | D |
| 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 | 4102 RICHMOND MDWS |
| Street Address 2 Of The Provider | |
| City Of The Provider | TEXARKANA |
| Zip Code Of The Provider | 755030067 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 188 |
| Number Of Services | 9809 |
| Number Of Medicare Beneficiaries | 5473 |
| Total Submitted Charge Amount | 850263.9 |
| Total Medicare Allowed Amount | 266611.49 |
| Total Medicare Payment Amount | 209451.52 |
| Total Medicare Standardized Payment Amount | 220197.59 |
| 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 | 9809 |
| Number Of Medicare Beneficiaries With Medical Services | 5473 |
| Total Medical Submitted Charge Amount | 850263.9 |
| Total Medical Medicare Allowed Amount | 266611.49 |
| Total Medical Medicare Payment Amount | 209451.52 |
| Total Medical Medicare Standardized Payment Amount | 220197.59 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 1137 |
| Number Of Beneficiaries Age 65 to 74 | 1987 |
| Number Of Beneficiaries Age 75 to 84 | 1552 |
| Number Of Beneficiaries Age Greater 84 | 797 |
| Number Of Female Beneficiaries | 3421 |
| Number Of Male Beneficiaries | 2052 |
| Number Of Non Hispanic White Beneficiaries | 4239 |
| Number Of Black or African American Beneficiaries | 1111 |
| Number Of AsianPacific Islander Beneficiaries | 16 |
| Number Of Hispanic Beneficiaries | 48 |
| Number Of American Indian Alaska Native Beneficiaries | 44 |
| Number Of Beneficiaries With Race Not Else where Classified | 15 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3768 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1705 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.585 |