| National Provider Identifier [NPI]: | 1225090715 |
| Last Name Of The Provider | CAMPBELL |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 301 FISHER ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | KEESLER AFB |
| Zip Code Of The Provider | 395342508 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 108 |
| Number Of Services | 3957 |
| Number Of Medicare Beneficiaries | 967 |
| Total Submitted Charge Amount | 1602819 |
| Total Medicare Allowed Amount | 414421.08 |
| Total Medicare Payment Amount | 310215.36 |
| Total Medicare Standardized Payment Amount | 333105.2 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 387 |
| Number Of Medicare Beneficiaries With Drug Services | 96 |
| Total Drug Submitted ChargeAmount | 28884 |
| Total Drug Medicare AllowedAmount | 20346.94 |
| Total Drug Medicare PaymentAmount | 15673.17 |
| Total Drug Medicare Standardized Payment Amount | 15673.17 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 106 |
| Number Of Medical Services | 3570 |
| Number Of Medicare Beneficiaries With Medical Services | 967 |
| Total Medical Submitted Charge Amount | 1573935 |
| Total Medical Medicare Allowed Amount | 394074.14 |
| Total Medical Medicare Payment Amount | 294542.19 |
| Total Medical Medicare Standardized Payment Amount | 317432.03 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 193 |
| Number Of Beneficiaries Age 65 to 74 | 354 |
| Number Of Beneficiaries Age 75 to 84 | 279 |
| Number Of Beneficiaries Age Greater 84 | 141 |
| Number Of Female Beneficiaries | 486 |
| Number Of Male Beneficiaries | 481 |
| Number Of Non Hispanic White Beneficiaries | 743 |
| Number Of Black or African American Beneficiaries | |
| 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 | 633 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 334 |
| Percent Of With Atrial Fibrillation | 24 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 44 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 74 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.5549 |