| National Provider Identifier [NPI]: | 1184801441 |
| Last Name Of The Provider | BALLISTY |
| First Name Of The Provider | MARIANNE |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 534 BILTMORE AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | ASHEVILLE |
| Zip Code Of The Provider | 288014612 |
| State Code Of The Provider | NC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 135 |
| Number Of Services | 15079 |
| Number Of Medicare Beneficiaries | 3264 |
| Total Submitted Charge Amount | 771170.5 |
| Total Medicare Allowed Amount | 223105.08 |
| Total Medicare Payment Amount | 172015.13 |
| Total Medicare Standardized Payment Amount | 184887.93 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 10593 |
| Number Of Medicare Beneficiaries With Drug Services | 133 |
| Total Drug Submitted ChargeAmount | 9317.5 |
| Total Drug Medicare AllowedAmount | 2435.1 |
| Total Drug Medicare PaymentAmount | 1908.85 |
| Total Drug Medicare Standardized Payment Amount | 1908.85 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 133 |
| Number Of Medical Services | 4486 |
| Number Of Medicare Beneficiaries With Medical Services | 3264 |
| Total Medical Submitted Charge Amount | 761853 |
| Total Medical Medicare Allowed Amount | 220669.98 |
| Total Medical Medicare Payment Amount | 170106.28 |
| Total Medical Medicare Standardized Payment Amount | 182979.08 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 651 |
| Number Of Beneficiaries Age 65 to 74 | 1210 |
| Number Of Beneficiaries Age 75 to 84 | 902 |
| Number Of Beneficiaries Age Greater 84 | 501 |
| Number Of Female Beneficiaries | 2019 |
| Number Of Male Beneficiaries | 1245 |
| Number Of Non Hispanic White Beneficiaries | 3055 |
| Number Of Black or African American Beneficiaries | 126 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 22 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 30 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2291 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 973 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.5171 |