| National Provider Identifier [NPI]: | 1902873623 |
| Last Name Of The Provider | CAMPBELL |
| First Name Of The Provider | DANA |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2196 MAIN STREET, SUITE H |
| Street Address 2 Of The Provider | |
| City Of The Provider | DUNEDIN |
| Zip Code Of The Provider | 346982524 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nephrology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 34 |
| Number Of Services | 5167 |
| Number Of Medicare Beneficiaries | 736 |
| Total Submitted Charge Amount | 1081347.82 |
| Total Medicare Allowed Amount | 543093.31 |
| Total Medicare Payment Amount | 423304.26 |
| Total Medicare Standardized Payment Amount | 421115.14 |
| 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 | 34 |
| Number Of Medical Services | 5167 |
| Number Of Medicare Beneficiaries With Medical Services | 736 |
| Total Medical Submitted Charge Amount | 1081347.82 |
| Total Medical Medicare Allowed Amount | 543093.31 |
| Total Medical Medicare Payment Amount | 423304.26 |
| Total Medical Medicare Standardized Payment Amount | 421115.14 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 111 |
| Number Of Beneficiaries Age 65 to 74 | 173 |
| Number Of Beneficiaries Age 75 to 84 | 241 |
| Number Of Beneficiaries Age Greater 84 | 211 |
| Number Of Female Beneficiaries | 358 |
| Number Of Male Beneficiaries | 378 |
| Number Of Non Hispanic White Beneficiaries | 660 |
| Number Of Black or African American Beneficiaries | 34 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 25 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 560 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 176 |
| Percent Of With Atrial Fibrillation | 33 |
| Percent Of With Alzheimers Disease or Dementia | 30 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 62 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 40 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 18 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 3.1665 |