| National Provider Identifier [NPI]: | 1871528042 |
| Last Name Of The Provider | FOX |
| First Name Of The Provider | EDWARD |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. PH.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 16040 PARK VALLEY DR |
| Street Address 2 Of The Provider | BUILDING B, SUITE 100 |
| City Of The Provider | ROUND ROCK |
| Zip Code Of The Provider | 786813578 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Neurology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 25 |
| Number Of Services | 32136 |
| Number Of Medicare Beneficiaries | 253 |
| Total Submitted Charge Amount | 1477478 |
| Total Medicare Allowed Amount | 555795.18 |
| Total Medicare Payment Amount | 407371.49 |
| Total Medicare Standardized Payment Amount | 414125.09 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 31301 |
| Number Of Medicare Beneficiaries With Drug Services | 26 |
| Total Drug Submitted ChargeAmount | 1291299 |
| Total Drug Medicare AllowedAmount | 472593.78 |
| Total Drug Medicare PaymentAmount | 351913.57 |
| Total Drug Medicare Standardized Payment Amount | 351913.57 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 21 |
| Number Of Medical Services | 835 |
| Number Of Medicare Beneficiaries With Medical Services | 253 |
| Total Medical Submitted Charge Amount | 186179 |
| Total Medical Medicare Allowed Amount | 83201.4 |
| Total Medical Medicare Payment Amount | 55457.92 |
| Total Medical Medicare Standardized Payment Amount | 62211.52 |
| Average Age Of Beneficiaries | 59 |
| Number Of Beneficiaries Age Less65 | 149 |
| Number Of Beneficiaries Age 65 to 74 | 89 |
| Number Of Beneficiaries Age 75 to 84 | 15 |
| Number Of Beneficiaries Age Greater 84 | 0 |
| Number Of Female Beneficiaries | 191 |
| Number Of Male Beneficiaries | 62 |
| Number Of Non Hispanic White Beneficiaries | 214 |
| Number Of Black or African American Beneficiaries | 16 |
| 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 | 202 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 51 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 7 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 10 |
| Percent Of With Hyperlipidemia | 29 |
| Percent Of With Hypertension | 32 |
| Percent Of With Ischemic Heart Disease | 10 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 20 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.423 |