| National Provider Identifier [NPI]: | 1588613491 |
| Last Name Of The Provider | CHANG |
| First Name Of The Provider | KEVIN |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 20 CATAMORE BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | EAST PROVIDENCE |
| Zip Code Of The Provider | 029141204 |
| State Code Of The Provider | RI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 154 |
| Number Of Services | 13679 |
| Number Of Medicare Beneficiaries | 2215 |
| Total Submitted Charge Amount | 608670 |
| Total Medicare Allowed Amount | 190528.21 |
| Total Medicare Payment Amount | 142027.35 |
| Total Medicare Standardized Payment Amount | 139932.98 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 10499 |
| Number Of Medicare Beneficiaries With Drug Services | 93 |
| Total Drug Submitted ChargeAmount | 10745 |
| Total Drug Medicare AllowedAmount | 4189.46 |
| Total Drug Medicare PaymentAmount | 3273.38 |
| Total Drug Medicare Standardized Payment Amount | 3273.38 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 149 |
| Number Of Medical Services | 3180 |
| Number Of Medicare Beneficiaries With Medical Services | 2214 |
| Total Medical Submitted Charge Amount | 597925 |
| Total Medical Medicare Allowed Amount | 186338.75 |
| Total Medical Medicare Payment Amount | 138753.97 |
| Total Medical Medicare Standardized Payment Amount | 136659.6 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 562 |
| Number Of Beneficiaries Age 65 to 74 | 753 |
| Number Of Beneficiaries Age 75 to 84 | 560 |
| Number Of Beneficiaries Age Greater 84 | 340 |
| Number Of Female Beneficiaries | 1275 |
| Number Of Male Beneficiaries | 940 |
| Number Of Non Hispanic White Beneficiaries | 1731 |
| Number Of Black or African American Beneficiaries | 122 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 268 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 52 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1402 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 813 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.8694 |