| National Provider Identifier [NPI]: | 1104823301 |
| Last Name Of The Provider | CHANG |
| First Name Of The Provider | HYUNSOO |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3300 BUCKEYE RD |
| Street Address 2 Of The Provider | SUITE178 |
| City Of The Provider | ATLANTA |
| Zip Code Of The Provider | 303414229 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 24 |
| Number Of Services | 2258 |
| Number Of Medicare Beneficiaries | 625 |
| Total Submitted Charge Amount | 403388 |
| Total Medicare Allowed Amount | 86539.93 |
| Total Medicare Payment Amount | 65142.15 |
| Total Medicare Standardized Payment Amount | 53035.56 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 24 |
| Number Of Medical Services | 2258 |
| Number Of Medicare Beneficiaries With Medical Services | 625 |
| Total Medical Submitted Charge Amount | 403388 |
| Total Medical Medicare Allowed Amount | 86539.93 |
| Total Medical Medicare Payment Amount | 65142.15 |
| Total Medical Medicare Standardized Payment Amount | 53035.56 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 65 |
| Number Of Beneficiaries Age 65 to 74 | 329 |
| Number Of Beneficiaries Age 75 to 84 | 178 |
| Number Of Beneficiaries Age Greater 84 | 53 |
| Number Of Female Beneficiaries | 371 |
| Number Of Male Beneficiaries | 254 |
| Number Of Non Hispanic White Beneficiaries | 549 |
| Number Of Black or African American Beneficiaries | 46 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 19 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 561 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 64 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 33 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.4613 |