| National Provider Identifier [NPI]: | 1902848393 |
| Last Name Of The Provider | MODI |
| First Name Of The Provider | JIGNYA |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7253 AMBASSADOR RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | BALTIMORE |
| Zip Code Of The Provider | 212442710 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 134 |
| Number Of Services | 44911 |
| Number Of Medicare Beneficiaries | 4715 |
| Total Submitted Charge Amount | 1754043.11 |
| Total Medicare Allowed Amount | 543322.71 |
| Total Medicare Payment Amount | 404883.07 |
| Total Medicare Standardized Payment Amount | 383253.48 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 38456 |
| Number Of Medicare Beneficiaries With Drug Services | 376 |
| Total Drug Submitted ChargeAmount | 8844.88 |
| Total Drug Medicare AllowedAmount | 7166.29 |
| Total Drug Medicare PaymentAmount | 5161.22 |
| Total Drug Medicare Standardized Payment Amount | 5161.22 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 133 |
| Number Of Medical Services | 6455 |
| Number Of Medicare Beneficiaries With Medical Services | 4715 |
| Total Medical Submitted Charge Amount | 1745198.23 |
| Total Medical Medicare Allowed Amount | 536156.42 |
| Total Medical Medicare Payment Amount | 399721.85 |
| Total Medical Medicare Standardized Payment Amount | 378092.26 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 701 |
| Number Of Beneficiaries Age 65 to 74 | 2000 |
| Number Of Beneficiaries Age 75 to 84 | 1349 |
| Number Of Beneficiaries Age Greater 84 | 665 |
| Number Of Female Beneficiaries | 3114 |
| Number Of Male Beneficiaries | 1601 |
| Number Of Non Hispanic White Beneficiaries | 3787 |
| Number Of Black or African American Beneficiaries | 716 |
| Number Of AsianPacific Islander Beneficiaries | 114 |
| Number Of Hispanic Beneficiaries | 55 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 3956 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 759 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.4745 |