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    v1.0.28
    OpenPayerNPI Medicare & MedicaidEdward Fox
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    Edward Fox — Billing Profile & Reimbursement Data

    NPI 1679546121 · Nashville, TN · Hematology & Oncology Physician

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    Edward Fox is a hematology & oncology physician provider located in Nashville, Tennessee. This profile covers 21 Medicare and 0 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationEdward Fox
    Address3601 The Vanderbilt Clinic
    CityNashville
    StateTN
    ZIP37232
    TaxonomyHematology & Oncology Physician
    NPI EnumeratedFebruary 7, 2006

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicare$222.7K
    Medicaid$0

    Medicare: Total Revenue Breakdown by CPT/HCPCS Code

    Medicare revenue breakdown by CPT/HCPCS procedure code.

    View: Bar Chart1 / 2

    Medicare: Complete Services Breakdown

    The CPT/HCPCS codes generating the most Medicare revenue for this provider.

    21 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    99214The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…1,210$90$106.6K
    99215The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…310$130$39.1K
    80053The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.1,480$10$14.8K
    85025A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…1,560$10$12.5K
    36415In this procedure, the provider inserts a needle into a vein to collect a blood sample.1,130$10$9K
    99205The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the provider…50$150$8K
    84443The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the…340$20$5.4K
    84481The lab analyst performs a test to measure free T3 in patient blood.260$20$4.4K
    83615The lab analyst measures the lactate dehydrogenase, typically in a serum sample. Lactate dehydrogenase is found in many body tissues, especially in the liver, kidney, and heart, and also in red blood…720$10$4.3K
    86300The lab analyst performs a quantitative test to evaluate the patient’s serum for the cancer tumor antigen CA 15 3, a tumor marker for breast cancer, and a similar marker called CA 27.29.170$20$3.3K

    Showing 1–10 of 21

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 21 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    21 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    992149811,370120$80$16.6K
    992332,2362,63090$90$13.1K
    99215582,71040$110$8.3K
    992232,9203,13040$120$8K
    992052171,30020$140$4.9K
    80053101,600160$10$4.3K
    84443211,37090$20$3.8K
    36415343,310120$10$3.2K
    85025201,870120$10$2.7K
    841536345030$20$2.5K

    Showing 1–10 of 21

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with Edward Fox, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Reena Jayani-kosarzyckiTNHematology & Oncology Physician$55.4K$0
    Meghan HoffmanTNPrimary Care Nurse Practitioner$31.1K$0
    Kathryn KennedyTNAcute Care Nurse Practitioner$30.2K$0
    Megan WancaTNFamily Nurse Practitioner$24.3K$0
    Melissa LogueTNFamily Nurse Practitioner$15.8K$0
    Benjamin TillmanTNHematology & Oncology Physician$13.4K$0
    Krista Kuhnert-gainerTNAcute Care Nurse Practitioner$10.2K$0

    Nearby Providers

    Other providers in the same ZIP code as Edward Fox, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Vanderbilt University Medical CenterTNInternal Medicine Physician$0$189.5M
    Vanderbilt University Medical CenterTNGeneral Acute Care Hospital$0$137.7M
    Vanderbilt University Medical CenterTNMental Health Clinic/Center (Including Community Mental Health Center)$0$29.1M
    Antonia KolokythasTNOral and Maxillofacial Surgery (Dentist)$0$5.9M
    Vanderbilt Integrated Providers, LLCTNFamily Medicine Physician$0$4.3M
    Han-chih ChangTNRadiation Oncology Physician$2.6M$0
    Emily CarpenterTNNurse Practitioner$747.9K$0
    Kenneth NiermannTNRadiation Oncology Physician$625.8K$0
    Stephen KimTNOphthalmology Physician$608.9K$0
    Corbin JohnsonTNRadiation Oncology Physician$577.1K$0

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. Tennessee Distribution
    Edward Fox — 7 of 21 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Tennessee