National Provider Identifier [NPI]: |
1285704460 |
Last Name Of The Provider |
FOX |
First Name Of The Provider |
IRA |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1056 SW 1ST AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
OCALA |
Zip Code Of The Provider |
344744221 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
24 |
Number Of Services |
3677 |
Number Of Medicare Beneficiaries |
173 |
Total Submitted Charge Amount |
285235.2 |
Total Medicare Allowed Amount |
200777.44 |
Total Medicare Payment Amount |
150382.04 |
Total Medicare Standardized Payment Amount |
147443.66 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
1438 |
Number Of Medicare Beneficiaries With Drug Services |
94 |
Total Drug Submitted ChargeAmount |
7715.2 |
Total Drug Medicare AllowedAmount |
4832.81 |
Total Drug Medicare PaymentAmount |
3957.61 |
Total Drug Medicare Standardized Payment Amount |
3957.61 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
22 |
Number Of Medical Services |
2239 |
Number Of Medicare Beneficiaries With Medical Services |
173 |
Total Medical Submitted Charge Amount |
277520 |
Total Medical Medicare Allowed Amount |
195944.63 |
Total Medical Medicare Payment Amount |
146424.43 |
Total Medical Medicare Standardized Payment Amount |
143486.05 |
Average Age Of Beneficiaries |
80 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
86 |
Number Of Beneficiaries Age Greater 84 |
44 |
Number Of Female Beneficiaries |
80 |
Number Of Male Beneficiaries |
93 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
34 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
|
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
36 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
11 |
Percent Of With Diabetes |
54 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.3648 |