| National Provider Identifier [NPI]: | 1578855920 |
| Last Name Of The Provider | CAMPBELL |
| First Name Of The Provider | AMY |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | PA |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1705 E 19TH ST |
| Street Address 2 Of The Provider | SUITE 302 |
| City Of The Provider | TULSA |
| Zip Code Of The Provider | 741045405 |
| State Code Of The Provider | OK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 80 |
| Number Of Services | 910 |
| Number Of Medicare Beneficiaries | 297 |
| Total Submitted Charge Amount | 63214 |
| Total Medicare Allowed Amount | 33689.9 |
| Total Medicare Payment Amount | 22148.83 |
| Total Medicare Standardized Payment Amount | 29266.09 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 297 |
| Number Of Medicare Beneficiaries With Drug Services | 54 |
| Total Drug Submitted ChargeAmount | 1583 |
| Total Drug Medicare AllowedAmount | 393.5 |
| Total Drug Medicare PaymentAmount | 278.34 |
| Total Drug Medicare Standardized Payment Amount | 278.34 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 67 |
| Number Of Medical Services | 613 |
| Number Of Medicare Beneficiaries With Medical Services | 297 |
| Total Medical Submitted Charge Amount | 61631 |
| Total Medical Medicare Allowed Amount | 33296.4 |
| Total Medical Medicare Payment Amount | 21870.49 |
| Total Medical Medicare Standardized Payment Amount | 28987.75 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 39 |
| Number Of Beneficiaries Age 65 to 74 | 161 |
| Number Of Beneficiaries Age 75 to 84 | 74 |
| Number Of Beneficiaries Age Greater 84 | 23 |
| Number Of Female Beneficiaries | 192 |
| Number Of Male Beneficiaries | 105 |
| Number Of Non Hispanic White Beneficiaries | 264 |
| 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 | 260 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 37 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8695 |