| National Provider Identifier [NPI]: | 1679551352 |
| Last Name Of The Provider | MODI |
| First Name Of The Provider | TUSHAR |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 413 E ORANGEBURG AVE |
| Street Address 2 Of The Provider | SUITE A |
| City Of The Provider | MODESTO |
| Zip Code Of The Provider | 953505315 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 65 |
| Number Of Services | 12400 |
| Number Of Medicare Beneficiaries | 859 |
| Total Submitted Charge Amount | 704449.62 |
| Total Medicare Allowed Amount | 599584.48 |
| Total Medicare Payment Amount | 459934.02 |
| Total Medicare Standardized Payment Amount | 450424.24 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 15 |
| Number Of Drug Services | 4164 |
| Number Of Medicare Beneficiaries With Drug Services | 575 |
| Total Drug Submitted ChargeAmount | 65706.89 |
| Total Drug Medicare AllowedAmount | 49885.02 |
| Total Drug Medicare PaymentAmount | 39964.61 |
| Total Drug Medicare Standardized Payment Amount | 39964.61 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 50 |
| Number Of Medical Services | 8236 |
| Number Of Medicare Beneficiaries With Medical Services | 859 |
| Total Medical Submitted Charge Amount | 638742.73 |
| Total Medical Medicare Allowed Amount | 549699.46 |
| Total Medical Medicare Payment Amount | 419969.41 |
| Total Medical Medicare Standardized Payment Amount | 410459.63 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 87 |
| Number Of Beneficiaries Age 65 to 74 | 280 |
| Number Of Beneficiaries Age 75 to 84 | 284 |
| Number Of Beneficiaries Age Greater 84 | 208 |
| Number Of Female Beneficiaries | 497 |
| Number Of Male Beneficiaries | 362 |
| Number Of Non Hispanic White Beneficiaries | 644 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 52 |
| Number Of Hispanic Beneficiaries | 124 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 18 |
| Number Of Beneficiaries With Medicare Only Entitlement | 617 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 242 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 63 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 59 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3553 |