| National Provider Identifier [NPI]: | 1184604167 |
| Last Name Of The Provider | CAMPOLO |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1930 TAMARACK RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | NEWARK |
| Zip Code Of The Provider | 430552303 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 127 |
| Number Of Services | 8535 |
| Number Of Medicare Beneficiaries | 816 |
| Total Submitted Charge Amount | 465036 |
| Total Medicare Allowed Amount | 312548.42 |
| Total Medicare Payment Amount | 235563.83 |
| Total Medicare Standardized Payment Amount | 243407.8 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 789 |
| Number Of Medicare Beneficiaries With Drug Services | 144 |
| Total Drug Submitted ChargeAmount | 22136 |
| Total Drug Medicare AllowedAmount | 10232.18 |
| Total Drug Medicare PaymentAmount | 8530.64 |
| Total Drug Medicare Standardized Payment Amount | 8530.64 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 114 |
| Number Of Medical Services | 7746 |
| Number Of Medicare Beneficiaries With Medical Services | 816 |
| Total Medical Submitted Charge Amount | 442900 |
| Total Medical Medicare Allowed Amount | 302316.24 |
| Total Medical Medicare Payment Amount | 227033.19 |
| Total Medical Medicare Standardized Payment Amount | 234877.16 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 171 |
| Number Of Beneficiaries Age 65 to 74 | 304 |
| Number Of Beneficiaries Age 75 to 84 | 203 |
| Number Of Beneficiaries Age Greater 84 | 138 |
| Number Of Female Beneficiaries | 439 |
| Number Of Male Beneficiaries | 377 |
| Number Of Non Hispanic White Beneficiaries | 789 |
| Number Of Black or African American Beneficiaries | 15 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 551 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 265 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 26 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.3774 |