| National Provider Identifier [NPI]: | 1669476693 |
| Last Name Of The Provider | WALLSHEIN |
| First Name Of The Provider | JAY |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5057 SOUTH CONGRESS AVE |
| Street Address 2 Of The Provider | STE 403 |
| City Of The Provider | ATLANTIS |
| Zip Code Of The Provider | 334614723 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 55 |
| Number Of Services | 6375.5 |
| Number Of Medicare Beneficiaries | 1486 |
| Total Submitted Charge Amount | 1712460 |
| Total Medicare Allowed Amount | 725841.03 |
| Total Medicare Payment Amount | 534122.49 |
| Total Medicare Standardized Payment Amount | 509683.96 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
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| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 59 |
| Number Of Beneficiaries Age 65 to 74 | 603 |
| Number Of Beneficiaries Age 75 to 84 | 488 |
| Number Of Beneficiaries Age Greater 84 | 336 |
| Number Of Female Beneficiaries | 892 |
| Number Of Male Beneficiaries | 594 |
| Number Of Non Hispanic White Beneficiaries | 1296 |
| Number Of Black or African American Beneficiaries | 79 |
| Number Of AsianPacific Islander Beneficiaries | 30 |
| Number Of Hispanic Beneficiaries | 61 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 20 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1330 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 156 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.2544 |