| National Provider Identifier [NPI]: | 1740490655 |
| Last Name Of The Provider | CAMPBELL |
| First Name Of The Provider | JASON |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1453 E BERT KOUNS INDUSTRIAL LOOP |
| Street Address 2 Of The Provider | ATTN: RADIOLOGY DEPT |
| City Of The Provider | SHREVEPORT |
| Zip Code Of The Provider | 711056800 |
| State Code Of The Provider | LA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 274 |
| Number Of Services | 5433 |
| Number Of Medicare Beneficiaries | 3106 |
| Total Submitted Charge Amount | 1075898 |
| Total Medicare Allowed Amount | 225561.38 |
| Total Medicare Payment Amount | 173191.92 |
| Total Medicare Standardized Payment Amount | 180560.16 |
| 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 | 274 |
| Number Of Medical Services | 5433 |
| Number Of Medicare Beneficiaries With Medical Services | 3106 |
| Total Medical Submitted Charge Amount | 1075898 |
| Total Medical Medicare Allowed Amount | 225561.38 |
| Total Medical Medicare Payment Amount | 173191.92 |
| Total Medical Medicare Standardized Payment Amount | 180560.16 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 533 |
| Number Of Beneficiaries Age 65 to 74 | 1146 |
| Number Of Beneficiaries Age 75 to 84 | 941 |
| Number Of Beneficiaries Age Greater 84 | 486 |
| Number Of Female Beneficiaries | 1869 |
| Number Of Male Beneficiaries | 1237 |
| Number Of Non Hispanic White Beneficiaries | 2175 |
| Number Of Black or African American Beneficiaries | 856 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 37 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 22 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2130 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 976 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 57 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.8758 |