| National Provider Identifier [NPI]: | 1669522819 |
| Last Name Of The Provider | ROHALY |
| First Name Of The Provider | EDWARD |
| 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 | 360 SAN MIGUEL DR STE 309 |
| Street Address 2 Of The Provider | |
| City Of The Provider | NEWPORT BEACH |
| Zip Code Of The Provider | 926607829 |
| 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 | 99 |
| Number Of Services | 11514 |
| Number Of Medicare Beneficiaries | 1090 |
| Total Submitted Charge Amount | 1197641.47 |
| Total Medicare Allowed Amount | 998427.26 |
| Total Medicare Payment Amount | 751043.93 |
| Total Medicare Standardized Payment Amount | 653120.87 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 91 |
| Number Of Medicare Beneficiaries With Drug Services | 57 |
| Total Drug Submitted ChargeAmount | 1820 |
| Total Drug Medicare AllowedAmount | 1550.76 |
| Total Drug Medicare PaymentAmount | 1211.51 |
| Total Drug Medicare Standardized Payment Amount | 1211.51 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 96 |
| Number Of Medical Services | 11423 |
| Number Of Medicare Beneficiaries With Medical Services | 1090 |
| Total Medical Submitted Charge Amount | 1195821.47 |
| Total Medical Medicare Allowed Amount | 996876.5 |
| Total Medical Medicare Payment Amount | 749832.42 |
| Total Medical Medicare Standardized Payment Amount | 651909.36 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 510 |
| Number Of Beneficiaries Age 75 to 84 | 402 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 496 |
| Number Of Male Beneficiaries | 594 |
| Number Of Non Hispanic White Beneficiaries | 1054 |
| 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 | 21 |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 5 |
| Percent Of With Depression | 9 |
| Percent Of With Diabetes | 17 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 54 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9129 |