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    OpenPayerNPI Medicare & MedicaidWilliam Wallace
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    William Wallace — Billing Profile & Reimbursement Data

    NPI 1528088960 · Laguna Hills, CA · Surgery Physician

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    William Wallace is a surgery physician provider located in Laguna Hills, California. This profile covers 12 Medicare and 0 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationWilliam Wallace
    Address24411 Health Center Dr
    CityLaguna Hills
    StateCA
    ZIP92653
    TaxonomySurgery Physician
    NPI EnumeratedJuly 20, 2006

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicare$69.8K
    Medicaid$0

    Medicare: Total Revenue Breakdown by CPT/HCPCS Code

    Medicare revenue breakdown by CPT/HCPCS procedure code.

    View: Bar Chart1 / 2

    Medicare: Complete Services Breakdown

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

    12 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    49507In this procedure, the provider surgically repairs an inguinal hernia that is incarcerated, meaning trapped, or strangulated, meaning the blood supply is cut off. Use this code for initial hernia…30$510$12.8K
    99204The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the provider…90$130$11.5K
    99223The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…60$140$8.3K
    49505The provider repairs an initial inguinal hernia on a child, five years of age or older. She pushes the hernia back to reduce it.20$460$6.9K
    55520In this procedure, the provider removes diseased or damaged tissue from the spermatic cord in the scrotum, the pouch that holds the testicles, to relieve pain or discomfort and or to restore…30$220$6.8K
    99233The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…60$100$6K
    99213The 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…70$70$5K
    99214The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…40$100$3.7K
    99232The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…50$70$3.4K
    99205The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the provider…20$150$3.1K

    Showing 1–10 of 12

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 12 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    12 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    992337,99111,530120$100$26.2K
    9921429,57737,970120$90$23.2K
    992328,04812,28090$70$16.3K
    495055611020$740$14.8K
    9921319,26834,66080$70$13.2K
    992235,25313,19050$140$11.3K
    4950721010$570$10.3K
    992055,5328,36030$170$7.2K
    992043,64019,36040$120$7.2K
    5552021020$280$5.4K

    Showing 1–10 of 12

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Tien NguyenCADermatology Physician$447.5K$2.2M
    Brian KimCAOphthalmology Physician$2.6M$8.9K
    Vivian LaquerCADermatology Physician$94.8K$1.7M
    Farah AwadallaCADermatology Physician$1.4M$320K
    Kenneth MartinezCANeurology Physician$1.6M$7.8K
    Sonia DhootCAOphthalmology Physician$1.5M$0
    Michael TruongCAEndocrinology, Diabetes & Metabolism Physician$1.2M$0
    Lynne HungCAClinical Cardiac Electrophysiology Physician$1.1M$0
    George ShahinianCAPulmonary Disease Physician$976.4K$2.2K
    Esrafil AbediCAOtolaryngology/Facial Plastic Surgery Physician$101.1K$806.2K

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Wilshire Pharmcare, Inc.CAPharmacy$114.3K$31M
    Pmdca, LLCCAClinical Medical Laboratory$906.1K$7M
    John HwangCARetina Specialist (Ophthalmology) Physician$1.9M$1.7M
    Charles EifrigCARetina Specialist (Ophthalmology) Physician$2.6M$885K
    Alicia Surgery Center LLCCAAmbulatory Surgical Clinic/Center$3.2M$0
    Pacific Hills Surgery Center LLCCAAmbulatory Surgical Clinic/Center$1.6M$15.2K
    Brandon MorrisCAFamily Nurse Practitioner$1.4M$0
    Prelude CorporationCAClinical Medical Laboratory$1M$9K
    Ali TabatabaiCASpecialist$1M$0
    Savak TeymoorianCAOphthalmology Physician$782.6K$0

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. California Distribution
    William Wallace — 0 of 12 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — California