National Provider Identifier [NPI]: |
1710999297 |
Last Name Of The Provider |
FOX |
First Name Of The Provider |
JOYCE |
Middle Initial Of The Provider |
N |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
200 N ROBERTSON BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
BEVERLY HILLS |
Zip Code Of The Provider |
902111769 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
53 |
Number Of Services |
2634 |
Number Of Medicare Beneficiaries |
500 |
Total Submitted Charge Amount |
560926 |
Total Medicare Allowed Amount |
177170.53 |
Total Medicare Payment Amount |
127544.01 |
Total Medicare Standardized Payment Amount |
114954.01 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
32 |
Number Of Medicare Beneficiaries With Drug Services |
13 |
Total Drug Submitted ChargeAmount |
1695 |
Total Drug Medicare AllowedAmount |
1250.23 |
Total Drug Medicare PaymentAmount |
977.42 |
Total Drug Medicare Standardized Payment Amount |
977.42 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
51 |
Number Of Medical Services |
2602 |
Number Of Medicare Beneficiaries With Medical Services |
499 |
Total Medical Submitted Charge Amount |
559231 |
Total Medical Medicare Allowed Amount |
175920.3 |
Total Medical Medicare Payment Amount |
126566.59 |
Total Medical Medicare Standardized Payment Amount |
113976.59 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
41 |
Number Of Beneficiaries Age 65 to 74 |
277 |
Number Of Beneficiaries Age 75 to 84 |
126 |
Number Of Beneficiaries Age Greater 84 |
56 |
Number Of Female Beneficiaries |
299 |
Number Of Male Beneficiaries |
201 |
Number Of Non Hispanic White Beneficiaries |
409 |
Number Of Black or African American Beneficiaries |
36 |
Number Of AsianPacific Islander Beneficiaries |
19 |
Number Of Hispanic Beneficiaries |
18 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
18 |
Number Of Beneficiaries With Medicare Only Entitlement |
415 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
85 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
5 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
19 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
48 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.0996 |