| National Provider Identifier [NPI]: | 1982741021 |
| Last Name Of The Provider | WALLACH |
| First Name Of The Provider | ADAM |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 400 EL CERRO BLVD |
| Street Address 2 Of The Provider | SUITE 204 |
| City Of The Provider | DANVILLE |
| Zip Code Of The Provider | 945261731 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 70 |
| Number Of Services | 7143 |
| Number Of Medicare Beneficiaries | 684 |
| Total Submitted Charge Amount | 809795 |
| Total Medicare Allowed Amount | 533745.02 |
| Total Medicare Payment Amount | 394011.77 |
| Total Medicare Standardized Payment Amount | 335963.4 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 106 |
| Number Of Medicare Beneficiaries With Drug Services | 68 |
| Total Drug Submitted ChargeAmount | 10287 |
| Total Drug Medicare AllowedAmount | 9925.37 |
| Total Drug Medicare PaymentAmount | 7772.37 |
| Total Drug Medicare Standardized Payment Amount | 7772.37 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 67 |
| Number Of Medical Services | 7037 |
| Number Of Medicare Beneficiaries With Medical Services | 684 |
| Total Medical Submitted Charge Amount | 799508 |
| Total Medical Medicare Allowed Amount | 523819.65 |
| Total Medical Medicare Payment Amount | 386239.4 |
| Total Medical Medicare Standardized Payment Amount | 328191.03 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 381 |
| Number Of Beneficiaries Age 75 to 84 | 219 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 312 |
| Number Of Male Beneficiaries | 372 |
| Number Of Non Hispanic White Beneficiaries | 657 |
| Number Of Black or African American Beneficiaries | |
| 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 | 684 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 0 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 5 |
| Percent Of With Depression | 10 |
| Percent Of With Diabetes | 15 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 51 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.8003 |