Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Florida for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Florida only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Florida (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Kenneth Wallace (NPI 1295791754)

Field	Value
Entity Type	Individual
Organization	Kenneth Wallace
Address	1091 Se 59th St
City	Ocala
State	FL
ZIP	34480
Taxonomy	MOHS-Micrographic Surgery Physician
NPI Enumerated	April 25, 2006

Payer Source	Total Paid
Medicare	$5.3M
Medicaid	$0

Key Findings

This provider’s Medicare activity is highly concentrated: total Medicare revenue is $5.3M and the precomputed top 3 Medicare codes by revenue account for 79.1% of that total. The single largest driver is Q4282 (2.6K claims, $1090 avg paid/claim, $2.8M revenue), which alone represents 53.4% of Medicare revenue, followed by Q4262 (827 claims, $1070 avg paid/claim, $884.9K revenue; 17.0%) and 77280 (2.2K claims, $203 avg paid/claim, $449.6K revenue; 8.6%).

The code mix suggests a hybrid practice profile centered on Mohs and skin-reconstruction products but with unusually high radiation therapy planning activity. Codes tied to skin surgery and reconstruction appear throughout the top services (for example, 17311 and 15275) while radiation-simulation and guidance codes (77280, G6001, 77285, 77290) together form a material portion of revenue, indicating either direct provision or consistent referral/billing capture for radiation planning services within the practice.

Payer mix is effectively single-payer Medicare: lifetime Medicare revenue is $5.3M and there is no Medicaid billing on file. The absence of any Medicaid billing suggests limited Medicaid patient exposure or that Medicaid-billed services are routed elsewhere, which is relevant to contracting and access analyses for payers evaluating network adequacy in Florida.

Several radiation-planning codes are statistical outliers relative to national peers, indicating exceptional volume for those services. Notably, 77280 ranks #27 of 3348 providers nationally at the 99th percentile and is described as an "extreme outlier, far above typical national volume," while 77285 ranks #2 of 67 (98th percentile; "notably above typical national volume") and 77290 ranks #120 of 3650 (97th percentile; "notably above typical national volume"). These high-percentile radiation codes contrast with the more typical national standing of the top skin-product codes.

Competitive standing varies by code: the dominant revenue source Q4282 ranks #2 of 3 providers nationally and is characterized as 50th percentile (typical, unremarkable volume), while Q4262 ranks #99 of 141 (30th percentile; typical, unremarkable volume). This combination means the provider derives most dollars from a Q-code product in a small national peer set but does not appear dominant among the broader population of providers for that product, whereas the provider is nationally prominent for several radiation-planning services.

Operational risk/consideration: multiple high-volume evaluation & management and minor-procedure codes are at or above the 97th–99th percentiles, which signals heavy throughput of office visits and repeat minor procedures. For example, 99213 (674 claims, $69 avg paid/claim, $46.5K revenue) ranks #15418 of 457151 providers (97th percentile; "notably above typical national volume") and 99212 (483 claims, $43 avg paid/claim, $20.8K revenue) ranks at the 99th percentile ("extreme outlier, far above typical national volume"), suggesting a steady stream of established-patient encounters supporting procedural workload.

The provider’s specialty taxonomy is MOHS-Micrographic Surgery Physician and the billing footprint includes classic Mohs codes (17311, 17312, 17313) and biopsy codes (11102, 11103), which supports the specialty alignment. At the same time, the unusually large volume of radiation-simulation codes implies either integrated service lines or a cross-specialty billing relationship that should be clarified when assessing service-line profitability and referral patterns.

Tenure is long-standing: the NPI was enumerated on 2006-04-25 (~20 years ago), indicating sustained enrollment and a multi-year billing record to evaluate trends. Also note a billing change to monitor going forward: 77401 is listed in the historical top codes but is marked "Deleted effective Jan. 1, 2026," which may affect future revenue mix and should be considered in forward-looking analyses.

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

52 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
Q4282	Cygnus dual, per square centimeter (add-on, list separately in addition to primary procedure)	2,550	$1,090	$2.8M
Q4262	Dual layer impax membrane, per square centimeter (add-on, list separately in addition to primary procedure)	830	$1,070	$884.9K
77280	The provider uses a simulator or other imaging modality to determine the size and location of ports to be used for radiation therapy. This code describes a simple level service.	2,220	$200	$449.6K
G6001	Ultrasonic guidance for placement of radiation therapy fields	2,140	$140	$291.6K
77285	In this procedure, the provider uses a simulator or other imaging modality to determine the size and location of ports to be used for radiation therapy.	400	$340	$133.8K
17311	Mohs surgery is a multi–staged procedure that is performed to excise a malignant lesion layer by layer, along with histo–pathological assessment. The assessment is performed to ensure that the…	230	$520	$121.6K
77401	Deleted effective Jan. 1, 2026.	2,150	$30	$66.5K
17312	Mohs surgery is a multi–staged method of excising a malignant lesion layer by layer, along with histo–pathological assessment, to ensure negative malignancy of the margins.	180	$320	$57K
77427	Radiation therapy utilizes ionizing radiation beams that are directed at cancerous cells in order to destroy them. The radiation, damages the DNA (the genetic material) in the cell, thus preventing…	380	$150	$56.7K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	670	$70	$46.5K

Showing 1–10 of 52

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 52 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Florida Distribution

Kenneth Wallace — 3 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Florida

Full comparison — all codes billed, vs. state median

52 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
Q4282	2	10	3,090	$1,090	$3.4M
Q4262	22	40	1,120	$1,000	$1.7M
17311	177	350	240	$470	$152.3K
G6001	4	20	440	$140	$115.6K
17312	127	330	120	$330	$61.8K
77285	2	10	50	$320	$58.3K
17313	165	280	60	$460	$45.9K
77427	65	370	160	$150	$36.3K
77280	4	310	50	$190	$27.4K
99214	14,702	32,760	140	$90	$25K

Showing 1–10 of 52

Related Providers

Other providers that share a Tax Identification Number (TIN) with Kenneth Wallace, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Neil Sandhu	FL	Dermatology Physician	$18.3M	$0
K Foster	FL	MOHS-Micrographic Surgery Physician	$1.1M	$0
David Kosiorek	FL	Physician Assistant	$852.2K	$0
Ammar Taha	WI	Diagnostic Radiology Physician	$410.5K	$380K
Ross Wheeler	FL	Dermatology Physician	$760.3K	$0
Brandon Worley	FL	MOHS-Micrographic Surgery Physician	$554.4K	$0
Saqib Ahmed	FL	MOHS-Micrographic Surgery Physician	$512K	$0
Eduardo Cruz-colon	FL	Physical Medicine & Rehabilitation Physician	$262.9K	$0
Pejman Taghavi	NJ	Diagnostic Radiology Physician	$260.8K	$0
Traci Zimmer	FL	Primary Care Nurse Practitioner	$251.2K	$0

Nearby Providers

Other providers in the same ZIP code as Kenneth Wallace, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ladden Herrmann	FL	Certified Registered Nurse Anesthetist	$161.4K	$0

Kenneth Wallace — Billing Profile & Reimbursement Data

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Kenneth Wallace — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References