| National Provider Identifier [NPI]: | 1629058300 |
| Last Name Of The Provider | FORSBERG |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1400 DOWELL SPRINGS BLVD |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | KNOXVILLE |
| Zip Code Of The Provider | 379092456 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 50 |
| Number Of Services | 67343 |
| Number Of Medicare Beneficiaries | 2940 |
| Total Submitted Charge Amount | 3551188.25 |
| Total Medicare Allowed Amount | 753653.74 |
| Total Medicare Payment Amount | 617045.25 |
| Total Medicare Standardized Payment Amount | 680248.9 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 61185 |
| Number Of Medicare Beneficiaries With Drug Services | 662 |
| Total Drug Submitted ChargeAmount | 33382.19 |
| Total Drug Medicare AllowedAmount | 12506 |
| Total Drug Medicare PaymentAmount | 9716.11 |
| Total Drug Medicare Standardized Payment Amount | 9716.11 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 45 |
| Number Of Medical Services | 6158 |
| Number Of Medicare Beneficiaries With Medical Services | 2933 |
| Total Medical Submitted Charge Amount | 3517806.06 |
| Total Medical Medicare Allowed Amount | 741147.74 |
| Total Medical Medicare Payment Amount | 607329.14 |
| Total Medical Medicare Standardized Payment Amount | 670532.79 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 310 |
| Number Of Beneficiaries Age 65 to 74 | 1659 |
| Number Of Beneficiaries Age 75 to 84 | 791 |
| Number Of Beneficiaries Age Greater 84 | 180 |
| Number Of Female Beneficiaries | 2167 |
| Number Of Male Beneficiaries | 773 |
| Number Of Non Hispanic White Beneficiaries | 2838 |
| Number Of Black or African American Beneficiaries | 63 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 25 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2652 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 288 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.8836 |