| National Provider Identifier [NPI]: | 1790775153 |
| Last Name Of The Provider | MODI |
| First Name Of The Provider | MAYANK |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2605 KEISER BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | WYOMISSING |
| Zip Code Of The Provider | 19610 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 91 |
| Number Of Services | 8742 |
| Number Of Medicare Beneficiaries | 2821 |
| Total Submitted Charge Amount | 1980925.32 |
| Total Medicare Allowed Amount | 849360.42 |
| Total Medicare Payment Amount | 647144.87 |
| Total Medicare Standardized Payment Amount | 680919.81 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 837 |
| Number Of Medicare Beneficiaries With Drug Services | 197 |
| Total Drug Submitted ChargeAmount | 40989.86 |
| Total Drug Medicare AllowedAmount | 40946.62 |
| Total Drug Medicare PaymentAmount | 32036.67 |
| Total Drug Medicare Standardized Payment Amount | 32036.67 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 88 |
| Number Of Medical Services | 7905 |
| Number Of Medicare Beneficiaries With Medical Services | 2821 |
| Total Medical Submitted Charge Amount | 1939935.46 |
| Total Medical Medicare Allowed Amount | 808413.8 |
| Total Medical Medicare Payment Amount | 615108.2 |
| Total Medical Medicare Standardized Payment Amount | 648883.14 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 259 |
| Number Of Beneficiaries Age 65 to 74 | 894 |
| Number Of Beneficiaries Age 75 to 84 | 1060 |
| Number Of Beneficiaries Age Greater 84 | 608 |
| Number Of Female Beneficiaries | 1386 |
| Number Of Male Beneficiaries | 1435 |
| Number Of Non Hispanic White Beneficiaries | 2582 |
| Number Of Black or African American Beneficiaries | 75 |
| Number Of AsianPacific Islander Beneficiaries | 16 |
| Number Of Hispanic Beneficiaries | 125 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 23 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2407 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 414 |
| Percent Of With Atrial Fibrillation | 33 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 41 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 68 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.6253 |