| National Provider Identifier [NPI]: | 1053405688 |
| Last Name Of The Provider | MODLINGER |
| First Name Of The Provider | PAUL |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3930 WALNUT STREET |
| Street Address 2 Of The Provider | SUITE 101 |
| City Of The Provider | FAIRFAX |
| Zip Code Of The Provider | 220304738 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nephrology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 28 |
| Number Of Services | 20453 |
| Number Of Medicare Beneficiaries | 873 |
| Total Submitted Charge Amount | 592875.78 |
| Total Medicare Allowed Amount | 384874.64 |
| Total Medicare Payment Amount | 293473.18 |
| Total Medicare Standardized Payment Amount | 271139.14 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 17859 |
| Number Of Medicare Beneficiaries With Drug Services | 45 |
| Total Drug Submitted ChargeAmount | 56616 |
| Total Drug Medicare AllowedAmount | 38639.1 |
| Total Drug Medicare PaymentAmount | 30158.43 |
| Total Drug Medicare Standardized Payment Amount | 30158.43 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 23 |
| Number Of Medical Services | 2594 |
| Number Of Medicare Beneficiaries With Medical Services | 873 |
| Total Medical Submitted Charge Amount | 536259.78 |
| Total Medical Medicare Allowed Amount | 346235.54 |
| Total Medical Medicare Payment Amount | 263314.75 |
| Total Medical Medicare Standardized Payment Amount | 240980.71 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 131 |
| Number Of Beneficiaries Age 65 to 74 | 282 |
| Number Of Beneficiaries Age 75 to 84 | 266 |
| Number Of Beneficiaries Age Greater 84 | 194 |
| Number Of Female Beneficiaries | 401 |
| Number Of Male Beneficiaries | 472 |
| Number Of Non Hispanic White Beneficiaries | 541 |
| Number Of Black or African American Beneficiaries | 171 |
| Number Of AsianPacific Islander Beneficiaries | 91 |
| Number Of Hispanic Beneficiaries | 57 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 13 |
| Number Of Beneficiaries With Medicare Only Entitlement | 671 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 202 |
| Percent Of With Atrial Fibrillation | 24 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 53 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 55 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 2.9074 |