| National Provider Identifier [NPI]: | 1356302798 |
| Last Name Of The Provider | FORTE |
| First Name Of The Provider | BILL |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3755 E VIRGINIA BEACH BLVD |
| Street Address 2 Of The Provider | NORFOLK COMMUNITY SERVICES BOARD |
| City Of The Provider | NORFOLK |
| Zip Code Of The Provider | 235023238 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Psychiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 5 |
| Number Of Services | 234 |
| Number Of Medicare Beneficiaries | 84 |
| Total Submitted Charge Amount | 20083.91 |
| Total Medicare Allowed Amount | 10533.36 |
| Total Medicare Payment Amount | 6731.88 |
| Total Medicare Standardized Payment Amount | 6865.11 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 28 |
| Number Of Medicare Beneficiaries With Drug Services | 14 |
| Total Drug Submitted ChargeAmount | 263.76 |
| Total Drug Medicare AllowedAmount | 263.76 |
| Total Drug Medicare PaymentAmount | 90.35 |
| Total Drug Medicare Standardized Payment Amount | 90.35 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 2 |
| Number Of Medical Services | 206 |
| Number Of Medicare Beneficiaries With Medical Services | 80 |
| Total Medical Submitted Charge Amount | 19820.15 |
| Total Medical Medicare Allowed Amount | 10269.6 |
| Total Medical Medicare Payment Amount | 6641.53 |
| Total Medical Medicare Standardized Payment Amount | 6774.76 |
| Average Age Of Beneficiaries | 52 |
| Number Of Beneficiaries Age Less65 | 71 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 47 |
| Number Of Male Beneficiaries | 37 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | 59 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 46 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 35 |
| Percent Of With Hypertension | 49 |
| Percent Of With Ischemic Heart Disease | |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 24 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 74 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2191 |