| National Provider Identifier [NPI]: | 1629003991 |
| Last Name Of The Provider | FOX |
| First Name Of The Provider | ERIC |
| 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 | 2 W FERN AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | REDLANDS |
| Zip Code Of The Provider | 923735916 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 49 |
| Number Of Services | 820 |
| Number Of Medicare Beneficiaries | 162 |
| Total Submitted Charge Amount | 55841.2 |
| Total Medicare Allowed Amount | 55512.52 |
| Total Medicare Payment Amount | 41831.11 |
| Total Medicare Standardized Payment Amount | 40681.04 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 92 |
| Number Of Medicare Beneficiaries With Drug Services | 30 |
| Total Drug Submitted ChargeAmount | 743.43 |
| Total Drug Medicare AllowedAmount | 725.12 |
| Total Drug Medicare PaymentAmount | 685.83 |
| Total Drug Medicare Standardized Payment Amount | 685.83 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 40 |
| Number Of Medical Services | 728 |
| Number Of Medicare Beneficiaries With Medical Services | 162 |
| Total Medical Submitted Charge Amount | 55097.77 |
| Total Medical Medicare Allowed Amount | 54787.4 |
| Total Medical Medicare Payment Amount | 41145.28 |
| Total Medical Medicare Standardized Payment Amount | 39995.21 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 29 |
| Number Of Beneficiaries Age 65 to 74 | 57 |
| Number Of Beneficiaries Age 75 to 84 | 44 |
| Number Of Beneficiaries Age Greater 84 | 32 |
| Number Of Female Beneficiaries | 88 |
| Number Of Male Beneficiaries | 74 |
| Number Of Non Hispanic White Beneficiaries | 123 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 26 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 118 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 44 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 2.0245 |