| National Provider Identifier [NPI]: | 1427237080 |
| Last Name Of The Provider | CAMPBELL |
| First Name Of The Provider | JUSTIN |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 121 N 20TH ST |
| Street Address 2 Of The Provider | #6 |
| City Of The Provider | OPELIKA |
| Zip Code Of The Provider | 368015449 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 83 |
| Number Of Services | 7388 |
| Number Of Medicare Beneficiaries | 1030 |
| Total Submitted Charge Amount | 412655 |
| Total Medicare Allowed Amount | 357665.34 |
| Total Medicare Payment Amount | 244542.81 |
| Total Medicare Standardized Payment Amount | 268283.98 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 17 |
| Number Of Drug Services | 3148 |
| Number Of Medicare Beneficiaries With Drug Services | 410 |
| Total Drug Submitted ChargeAmount | 49545 |
| Total Drug Medicare AllowedAmount | 39134.14 |
| Total Drug Medicare PaymentAmount | 31443.34 |
| Total Drug Medicare Standardized Payment Amount | 31443.34 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 66 |
| Number Of Medical Services | 4240 |
| Number Of Medicare Beneficiaries With Medical Services | 1030 |
| Total Medical Submitted Charge Amount | 363110 |
| Total Medical Medicare Allowed Amount | 318531.2 |
| Total Medical Medicare Payment Amount | 213099.47 |
| Total Medical Medicare Standardized Payment Amount | 236840.64 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 117 |
| Number Of Beneficiaries Age 65 to 74 | 454 |
| Number Of Beneficiaries Age 75 to 84 | 318 |
| Number Of Beneficiaries Age Greater 84 | 141 |
| Number Of Female Beneficiaries | 612 |
| Number Of Male Beneficiaries | 418 |
| Number Of Non Hispanic White Beneficiaries | 734 |
| 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 | 868 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 162 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 8 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0537 |