| National Provider Identifier [NPI]: | 1366492761 |
| Last Name Of The Provider | CAMPBELL |
| First Name Of The Provider | TODD |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7138 OAK VALLEY DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | COLORADO SPRINGS |
| Zip Code Of The Provider | 809193409 |
| State Code Of The Provider | CO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 116 |
| Number Of Services | 1934 |
| Number Of Medicare Beneficiaries | 1545 |
| Total Submitted Charge Amount | 245490.18 |
| Total Medicare Allowed Amount | 59656.08 |
| Total Medicare Payment Amount | 40828.03 |
| Total Medicare Standardized Payment Amount | 43544.24 |
| 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 | 116 |
| Number Of Medical Services | 1934 |
| Number Of Medicare Beneficiaries With Medical Services | 1545 |
| Total Medical Submitted Charge Amount | 245490.18 |
| Total Medical Medicare Allowed Amount | 59656.08 |
| Total Medical Medicare Payment Amount | 40828.03 |
| Total Medical Medicare Standardized Payment Amount | 43544.24 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 415 |
| Number Of Beneficiaries Age 65 to 74 | 469 |
| Number Of Beneficiaries Age 75 to 84 | 411 |
| Number Of Beneficiaries Age Greater 84 | 250 |
| Number Of Female Beneficiaries | 933 |
| Number Of Male Beneficiaries | 612 |
| Number Of Non Hispanic White Beneficiaries | 1074 |
| Number Of Black or African American Beneficiaries | 54 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 23 |
| Number Of American Indian Alaska Native Beneficiaries | 383 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 899 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 646 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 24 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 41 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 56 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.7042 |