| National Provider Identifier [NPI]: | 1346260460 |
| Last Name Of The Provider | FOX |
| First Name Of The Provider | ERVIN |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2500 NORTH STATE STREET |
| Street Address 2 Of The Provider | DEPARTMENT OF MEDICINE/DIVISION OF CARDIOLOGY |
| City Of The Provider | JACKSON |
| Zip Code Of The Provider | 392164500 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 22 |
| Number Of Services | 1834 |
| Number Of Medicare Beneficiaries | 1171 |
| Total Submitted Charge Amount | 428073.2 |
| Total Medicare Allowed Amount | 96911.39 |
| Total Medicare Payment Amount | 74265.35 |
| Total Medicare Standardized Payment Amount | 78117.54 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 22 |
| Number Of Medical Services | 1834 |
| Number Of Medicare Beneficiaries With Medical Services | 1171 |
| Total Medical Submitted Charge Amount | 428073.2 |
| Total Medical Medicare Allowed Amount | 96911.39 |
| Total Medical Medicare Payment Amount | 74265.35 |
| Total Medical Medicare Standardized Payment Amount | 78117.54 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 431 |
| Number Of Beneficiaries Age 65 to 74 | 389 |
| Number Of Beneficiaries Age 75 to 84 | 243 |
| Number Of Beneficiaries Age Greater 84 | 108 |
| Number Of Female Beneficiaries | 571 |
| Number Of Male Beneficiaries | 600 |
| Number Of Non Hispanic White Beneficiaries | 576 |
| Number Of Black or African American Beneficiaries | 579 |
| 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 | 587 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 584 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 51 |
| Percent Of With Chronic Kidney Disease | 52 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 57 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 17 |
| Average HCC Risk Score Of Beneficiaries | 2.2918 |