| National Provider Identifier [NPI]: | 1063429470 |
| Last Name Of The Provider | CAMPBELL |
| First Name Of The Provider | GLENN |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 104 MILLSAPS DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | HATTIESBURG |
| Zip Code Of The Provider | 394021328 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 52 |
| Number Of Services | 4683 |
| Number Of Medicare Beneficiaries | 529 |
| Total Submitted Charge Amount | 243585 |
| Total Medicare Allowed Amount | 128608.73 |
| Total Medicare Payment Amount | 93790.91 |
| Total Medicare Standardized Payment Amount | 102297.86 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 428 |
| Number Of Medicare Beneficiaries With Drug Services | 233 |
| Total Drug Submitted ChargeAmount | 17333 |
| Total Drug Medicare AllowedAmount | 5926 |
| Total Drug Medicare PaymentAmount | 5538.7 |
| Total Drug Medicare Standardized Payment Amount | 5538.7 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 45 |
| Number Of Medical Services | 4255 |
| Number Of Medicare Beneficiaries With Medical Services | 529 |
| Total Medical Submitted Charge Amount | 226252 |
| Total Medical Medicare Allowed Amount | 122682.73 |
| Total Medical Medicare Payment Amount | 88252.21 |
| Total Medical Medicare Standardized Payment Amount | 96759.16 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 57 |
| Number Of Beneficiaries Age 65 to 74 | 260 |
| Number Of Beneficiaries Age 75 to 84 | 138 |
| Number Of Beneficiaries Age Greater 84 | 74 |
| Number Of Female Beneficiaries | 301 |
| Number Of Male Beneficiaries | 228 |
| Number Of Non Hispanic White Beneficiaries | 436 |
| 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 | 454 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 75 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 0.9172 |