| National Provider Identifier [NPI]: | 1013965011 |
| Last Name Of The Provider | BALDASSANO |
| First Name Of The Provider | MARISA |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 828 CREEKVIEW DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | BLUE BELL |
| Zip Code Of The Provider | 194222729 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 6 |
| Number Of Services | 7194 |
| Number Of Medicare Beneficiaries | 3476 |
| Total Submitted Charge Amount | 775653 |
| Total Medicare Allowed Amount | 392688.68 |
| Total Medicare Payment Amount | 298487.45 |
| Total Medicare Standardized Payment Amount | 213868.32 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 6 |
| Number Of Medical Services | 7194 |
| Number Of Medicare Beneficiaries With Medical Services | 3476 |
| Total Medical Submitted Charge Amount | 775653 |
| Total Medical Medicare Allowed Amount | 392688.68 |
| Total Medical Medicare Payment Amount | 298487.45 |
| Total Medical Medicare Standardized Payment Amount | 213868.32 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 103 |
| Number Of Beneficiaries Age 65 to 74 | 1232 |
| Number Of Beneficiaries Age 75 to 84 | 1337 |
| Number Of Beneficiaries Age Greater 84 | 804 |
| Number Of Female Beneficiaries | 1803 |
| Number Of Male Beneficiaries | 1673 |
| Number Of Non Hispanic White Beneficiaries | 3366 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 33 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 40 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3348 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 128 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1058 |