National Provider Identifier [NPI]: |
1184601957 |
Last Name Of The Provider |
CAMPBELL |
First Name Of The Provider |
DON |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1150 E SHERMAN BLVD |
Street Address 2 Of The Provider |
SUITE 1100 |
City Of The Provider |
MUSKEGON |
Zip Code Of The Provider |
494441871 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
2302 |
Number Of Medicare Beneficiaries |
1311 |
Total Submitted Charge Amount |
174605 |
Total Medicare Allowed Amount |
70801.34 |
Total Medicare Payment Amount |
47458.31 |
Total Medicare Standardized Payment Amount |
48502.68 |
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 |
19 |
Number Of Medical Services |
2302 |
Number Of Medicare Beneficiaries With Medical Services |
1311 |
Total Medical Submitted Charge Amount |
174605 |
Total Medical Medicare Allowed Amount |
70801.34 |
Total Medical Medicare Payment Amount |
47458.31 |
Total Medical Medicare Standardized Payment Amount |
48502.68 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
330 |
Number Of Beneficiaries Age 65 to 74 |
386 |
Number Of Beneficiaries Age 75 to 84 |
357 |
Number Of Beneficiaries Age Greater 84 |
238 |
Number Of Female Beneficiaries |
707 |
Number Of Male Beneficiaries |
604 |
Number Of Non Hispanic White Beneficiaries |
1062 |
Number Of Black or African American Beneficiaries |
202 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
30 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
871 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
440 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
37 |
Percent Of With Chronic Kidney Disease |
45 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.8532 |