| National Provider Identifier [NPI]: | 1568417772 |
| Last Name Of The Provider | THORSTAD |
| First Name Of The Provider | BRETT |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3024 BUSINESS PARK CIR |
| Street Address 2 Of The Provider | |
| City Of The Provider | GOODLETTSVILLE |
| Zip Code Of The Provider | 370723132 |
| 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 | 223 |
| Number Of Services | 8773 |
| Number Of Medicare Beneficiaries | 2851 |
| Total Submitted Charge Amount | 1090848.46 |
| Total Medicare Allowed Amount | 203482.75 |
| Total Medicare Payment Amount | 157454.04 |
| Total Medicare Standardized Payment Amount | 169920.21 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 4118 |
| Number Of Medicare Beneficiaries With Drug Services | 53 |
| Total Drug Submitted ChargeAmount | 1482.67 |
| Total Drug Medicare AllowedAmount | 1021.18 |
| Total Drug Medicare PaymentAmount | 728.96 |
| Total Drug Medicare Standardized Payment Amount | 728.96 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 214 |
| Number Of Medical Services | 4655 |
| Number Of Medicare Beneficiaries With Medical Services | 2851 |
| Total Medical Submitted Charge Amount | 1089365.79 |
| Total Medical Medicare Allowed Amount | 202461.57 |
| Total Medical Medicare Payment Amount | 156725.08 |
| Total Medical Medicare Standardized Payment Amount | 169191.25 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 443 |
| Number Of Beneficiaries Age 65 to 74 | 1209 |
| Number Of Beneficiaries Age 75 to 84 | 839 |
| Number Of Beneficiaries Age Greater 84 | 360 |
| Number Of Female Beneficiaries | 1954 |
| Number Of Male Beneficiaries | 897 |
| Number Of Non Hispanic White Beneficiaries | 2430 |
| Number Of Black or African American Beneficiaries | 363 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 18 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 29 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2305 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 546 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.5622 |