| National Provider Identifier [NPI]: | 1215973482 |
| Last Name Of The Provider | CAMPBELL |
| First Name Of The Provider | ROSS |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1500 OGLETHORPE AVE |
| Street Address 2 Of The Provider | SUITE 300A |
| City Of The Provider | ATHENS |
| Zip Code Of The Provider | 306062179 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 116 |
| Number Of Services | 14290 |
| Number Of Medicare Beneficiaries | 2230 |
| Total Submitted Charge Amount | 5772908.93 |
| Total Medicare Allowed Amount | 2341557.85 |
| Total Medicare Payment Amount | 1765329.96 |
| Total Medicare Standardized Payment Amount | 1933576.14 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 33 |
| Number Of Medicare Beneficiaries With Drug Services | 23 |
| Total Drug Submitted ChargeAmount | 82.5 |
| Total Drug Medicare AllowedAmount | 58.86 |
| Total Drug Medicare PaymentAmount | 40.51 |
| Total Drug Medicare Standardized Payment Amount | 40.51 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 115 |
| Number Of Medical Services | 14257 |
| Number Of Medicare Beneficiaries With Medical Services | 2230 |
| Total Medical Submitted Charge Amount | 5772826.43 |
| Total Medical Medicare Allowed Amount | 2341498.99 |
| Total Medical Medicare Payment Amount | 1765289.45 |
| Total Medical Medicare Standardized Payment Amount | 1933535.63 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 80 |
| Number Of Beneficiaries Age 65 to 74 | 1117 |
| Number Of Beneficiaries Age 75 to 84 | 771 |
| Number Of Beneficiaries Age Greater 84 | 262 |
| Number Of Female Beneficiaries | 946 |
| Number Of Male Beneficiaries | 1284 |
| Number Of Non Hispanic White Beneficiaries | 2175 |
| Number Of Black or African American Beneficiaries | 18 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 26 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2091 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 139 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9882 |