| National Provider Identifier [NPI]: | 1356460018 |
| Last Name Of The Provider | ZALLA |
| First Name Of The Provider | MARK |
| 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 | 7766 EWING BLVD |
| Street Address 2 Of The Provider | STE 100 |
| City Of The Provider | FLORENCE |
| Zip Code Of The Provider | 410427538 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 107 |
| Number Of Services | 2684 |
| Number Of Medicare Beneficiaries | 733 |
| Total Submitted Charge Amount | 574694.2 |
| Total Medicare Allowed Amount | 337116.22 |
| Total Medicare Payment Amount | 253649.61 |
| Total Medicare Standardized Payment Amount | 272393.15 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 39 |
| Number Of Medicare Beneficiaries With Drug Services | 16 |
| Total Drug Submitted ChargeAmount | 8127.86 |
| Total Drug Medicare AllowedAmount | 6022.65 |
| Total Drug Medicare PaymentAmount | 4691.03 |
| Total Drug Medicare Standardized Payment Amount | 4691.03 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 105 |
| Number Of Medical Services | 2645 |
| Number Of Medicare Beneficiaries With Medical Services | 733 |
| Total Medical Submitted Charge Amount | 566566.34 |
| Total Medical Medicare Allowed Amount | 331093.57 |
| Total Medical Medicare Payment Amount | 248958.58 |
| Total Medical Medicare Standardized Payment Amount | 267702.12 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 35 |
| Number Of Beneficiaries Age 65 to 74 | 344 |
| Number Of Beneficiaries Age 75 to 84 | 247 |
| Number Of Beneficiaries Age Greater 84 | 107 |
| Number Of Female Beneficiaries | 373 |
| Number Of Male Beneficiaries | 360 |
| Number Of Non Hispanic White Beneficiaries | 717 |
| Number Of Black or African American Beneficiaries | |
| 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 | 702 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 31 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0982 |