| National Provider Identifier [NPI]: | 1710987391 |
| Last Name Of The Provider | WALLACH |
| First Name Of The Provider | PETER |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1480 N UNIVERSITY DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | CORAL SPRINGS |
| Zip Code Of The Provider | 330716040 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 62 |
| Number Of Services | 8416 |
| Number Of Medicare Beneficiaries | 1256 |
| Total Submitted Charge Amount | 900979.49 |
| Total Medicare Allowed Amount | 635548.96 |
| Total Medicare Payment Amount | 465878.99 |
| Total Medicare Standardized Payment Amount | 436459.44 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 168 |
| Number Of Medicare Beneficiaries With Drug Services | 68 |
| Total Drug Submitted ChargeAmount | 7576 |
| Total Drug Medicare AllowedAmount | 6675.63 |
| Total Drug Medicare PaymentAmount | 5030.31 |
| Total Drug Medicare Standardized Payment Amount | 5030.31 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 60 |
| Number Of Medical Services | 8248 |
| Number Of Medicare Beneficiaries With Medical Services | 1256 |
| Total Medical Submitted Charge Amount | 893403.49 |
| Total Medical Medicare Allowed Amount | 628873.33 |
| Total Medical Medicare Payment Amount | 460848.68 |
| Total Medical Medicare Standardized Payment Amount | 431429.13 |
| Average Age Of Beneficiaries | 79 |
| Number Of Beneficiaries Age Less65 | 59 |
| Number Of Beneficiaries Age 65 to 74 | 412 |
| Number Of Beneficiaries Age 75 to 84 | 351 |
| Number Of Beneficiaries Age Greater 84 | 434 |
| Number Of Female Beneficiaries | 719 |
| Number Of Male Beneficiaries | 537 |
| Number Of Non Hispanic White Beneficiaries | 1165 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 50 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 21 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1187 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 69 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2417 |