| National Provider Identifier [NPI]: | 1295795664 |
| Last Name Of The Provider | FORREST |
| First Name Of The Provider | NATHAN |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6901 MEDICAL PKWY |
| Street Address 2 Of The Provider | RADIOLOGY DEPARTMENT |
| City Of The Provider | WACO |
| Zip Code Of The Provider | 767127910 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 132 |
| Number Of Services | 7255 |
| Number Of Medicare Beneficiaries | 4060 |
| Total Submitted Charge Amount | 701218 |
| Total Medicare Allowed Amount | 170192.93 |
| Total Medicare Payment Amount | 125382.62 |
| Total Medicare Standardized Payment Amount | 131848.41 |
| 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 | 132 |
| Number Of Medical Services | 7255 |
| Number Of Medicare Beneficiaries With Medical Services | 4060 |
| Total Medical Submitted Charge Amount | 701218 |
| Total Medical Medicare Allowed Amount | 170192.93 |
| Total Medical Medicare Payment Amount | 125382.62 |
| Total Medical Medicare Standardized Payment Amount | 131848.41 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 882 |
| Number Of Beneficiaries Age 65 to 74 | 1356 |
| Number Of Beneficiaries Age 75 to 84 | 1180 |
| Number Of Beneficiaries Age Greater 84 | 642 |
| Number Of Female Beneficiaries | 2430 |
| Number Of Male Beneficiaries | 1630 |
| Number Of Non Hispanic White Beneficiaries | 3065 |
| Number Of Black or African American Beneficiaries | 602 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 364 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 18 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2821 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1239 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.7146 |