| National Provider Identifier [NPI]: | 1184618837 |
| Last Name Of The Provider | FORREST |
| First Name Of The Provider | TERRY |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 103 COX BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | GOLDSBORO |
| Zip Code Of The Provider | 275349478 |
| State Code Of The Provider | NC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 60 |
| Number Of Services | 6845 |
| Number Of Medicare Beneficiaries | 1959 |
| Total Submitted Charge Amount | 2188521 |
| Total Medicare Allowed Amount | 1182979.57 |
| Total Medicare Payment Amount | 888463.65 |
| Total Medicare Standardized Payment Amount | 912128.24 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 506 |
| Number Of Medicare Beneficiaries With Drug Services | 52 |
| Total Drug Submitted ChargeAmount | 453619 |
| Total Drug Medicare AllowedAmount | 355564.84 |
| Total Drug Medicare PaymentAmount | 278726.32 |
| Total Drug Medicare Standardized Payment Amount | 278726.32 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 56 |
| Number Of Medical Services | 6339 |
| Number Of Medicare Beneficiaries With Medical Services | 1959 |
| Total Medical Submitted Charge Amount | 1734902 |
| Total Medical Medicare Allowed Amount | 827414.73 |
| Total Medical Medicare Payment Amount | 609737.33 |
| Total Medical Medicare Standardized Payment Amount | 633401.92 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 106 |
| Number Of Beneficiaries Age 65 to 74 | 696 |
| Number Of Beneficiaries Age 75 to 84 | 793 |
| Number Of Beneficiaries Age Greater 84 | 364 |
| Number Of Female Beneficiaries | 1308 |
| Number Of Male Beneficiaries | 651 |
| Number Of Non Hispanic White Beneficiaries | 1686 |
| Number Of Black or African American Beneficiaries | 250 |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1699 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 260 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0689 |