| National Provider Identifier [NPI]: | 1679534663 |
| Last Name Of The Provider | FOX |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | LEE ST FL 1 |
| Street Address 2 Of The Provider | |
| City Of The Provider | CHARLOTTESVILLE |
| Zip Code Of The Provider | 229080001 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 107 |
| Number Of Services | 3880 |
| Number Of Medicare Beneficiaries | 1389 |
| Total Submitted Charge Amount | 1335982.6 |
| Total Medicare Allowed Amount | 121655.68 |
| Total Medicare Payment Amount | 92432.35 |
| Total Medicare Standardized Payment Amount | 95219.39 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 764 |
| Number Of Medicare Beneficiaries With Drug Services | 84 |
| Total Drug Submitted ChargeAmount | 6862.6 |
| Total Drug Medicare AllowedAmount | 1328.01 |
| Total Drug Medicare PaymentAmount | 1041.18 |
| Total Drug Medicare Standardized Payment Amount | 1041.18 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 101 |
| Number Of Medical Services | 3116 |
| Number Of Medicare Beneficiaries With Medical Services | 1389 |
| Total Medical Submitted Charge Amount | 1329120 |
| Total Medical Medicare Allowed Amount | 120327.67 |
| Total Medical Medicare Payment Amount | 91391.17 |
| Total Medical Medicare Standardized Payment Amount | 94178.21 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 392 |
| Number Of Beneficiaries Age 65 to 74 | 558 |
| Number Of Beneficiaries Age 75 to 84 | 305 |
| Number Of Beneficiaries Age Greater 84 | 134 |
| Number Of Female Beneficiaries | 844 |
| Number Of Male Beneficiaries | 545 |
| Number Of Non Hispanic White Beneficiaries | 1156 |
| Number Of Black or African American Beneficiaries | 207 |
| 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 | 14 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1014 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 375 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 70 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.5049 |