| National Provider Identifier [NPI]: | 1265541056 |
| Last Name Of The Provider | CAMPO |
| First Name Of The Provider | ALFONSE |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 605 WEST AVE |
| Street Address 2 Of The Provider | SUITE 305 |
| City Of The Provider | NORWALK |
| Zip Code Of The Provider | 068504000 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 29 |
| Number Of Services | 1186 |
| Number Of Medicare Beneficiaries | 202 |
| Total Submitted Charge Amount | 133925 |
| Total Medicare Allowed Amount | 80855.74 |
| Total Medicare Payment Amount | 58032.62 |
| Total Medicare Standardized Payment Amount | 51979.35 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 32 |
| Number Of Medicare Beneficiaries With Drug Services | 27 |
| Total Drug Submitted ChargeAmount | 1375 |
| Total Drug Medicare AllowedAmount | 1032.99 |
| Total Drug Medicare PaymentAmount | 1010.26 |
| Total Drug Medicare Standardized Payment Amount | 1010.26 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 25 |
| Number Of Medical Services | 1154 |
| Number Of Medicare Beneficiaries With Medical Services | 202 |
| Total Medical Submitted Charge Amount | 132550 |
| Total Medical Medicare Allowed Amount | 79822.75 |
| Total Medical Medicare Payment Amount | 57022.36 |
| Total Medical Medicare Standardized Payment Amount | 50969.09 |
| Average Age Of Beneficiaries | 79 |
| Number Of Beneficiaries Age Less65 | 14 |
| Number Of Beneficiaries Age 65 to 74 | 54 |
| Number Of Beneficiaries Age 75 to 84 | 57 |
| Number Of Beneficiaries Age Greater 84 | 77 |
| Number Of Female Beneficiaries | 131 |
| Number Of Male Beneficiaries | 71 |
| Number Of Non Hispanic White Beneficiaries | 176 |
| 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 | 177 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 25 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 37 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 34 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 29 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.1875 |