National Provider Identifier [NPI]: |
1356383582 |
Last Name Of The Provider |
FOX |
First Name Of The Provider |
THOMAS |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1027 BELLEVUE AVE |
Street Address 2 Of The Provider |
SUITE 25 |
City Of The Provider |
SAINT LOUIS |
Zip Code Of The Provider |
631171851 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
103 |
Number Of Services |
6654 |
Number Of Medicare Beneficiaries |
634 |
Total Submitted Charge Amount |
1457920.1 |
Total Medicare Allowed Amount |
280579.47 |
Total Medicare Payment Amount |
207515.3 |
Total Medicare Standardized Payment Amount |
210670.85 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
4125 |
Number Of Medicare Beneficiaries With Drug Services |
282 |
Total Drug Submitted ChargeAmount |
65035 |
Total Drug Medicare AllowedAmount |
17151.26 |
Total Drug Medicare PaymentAmount |
13025.93 |
Total Drug Medicare Standardized Payment Amount |
13025.93 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
99 |
Number Of Medical Services |
2529 |
Number Of Medicare Beneficiaries With Medical Services |
634 |
Total Medical Submitted Charge Amount |
1392885.1 |
Total Medical Medicare Allowed Amount |
263428.21 |
Total Medical Medicare Payment Amount |
194489.37 |
Total Medical Medicare Standardized Payment Amount |
197644.92 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
72 |
Number Of Beneficiaries Age 65 to 74 |
236 |
Number Of Beneficiaries Age 75 to 84 |
205 |
Number Of Beneficiaries Age Greater 84 |
121 |
Number Of Female Beneficiaries |
447 |
Number Of Male Beneficiaries |
187 |
Number Of Non Hispanic White Beneficiaries |
466 |
Number Of Black or African American Beneficiaries |
151 |
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 |
545 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
89 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
72 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.2994 |