| National Provider Identifier [NPI]: | 1629192125 |
| Last Name Of The Provider | CHANG |
| First Name Of The Provider | CONNIE |
| Middle Initial Of The Provider | Y |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 55 FRUIT ST |
| Street Address 2 Of The Provider | YAWKEY 6E |
| City Of The Provider | BOSTON |
| Zip Code Of The Provider | 021142621 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 144 |
| Number Of Services | 5641 |
| Number Of Medicare Beneficiaries | 3325 |
| Total Submitted Charge Amount | 1145495 |
| Total Medicare Allowed Amount | 202069.56 |
| Total Medicare Payment Amount | 152253.39 |
| Total Medicare Standardized Payment Amount | 142125.94 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 661 |
| Number Of Medicare Beneficiaries With Drug Services | 39 |
| Total Drug Submitted ChargeAmount | 5149 |
| Total Drug Medicare AllowedAmount | 1132.46 |
| Total Drug Medicare PaymentAmount | 887.84 |
| Total Drug Medicare Standardized Payment Amount | 887.84 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 142 |
| Number Of Medical Services | 4980 |
| Number Of Medicare Beneficiaries With Medical Services | 3325 |
| Total Medical Submitted Charge Amount | 1140346 |
| Total Medical Medicare Allowed Amount | 200937.1 |
| Total Medical Medicare Payment Amount | 151365.55 |
| Total Medical Medicare Standardized Payment Amount | 141238.1 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 548 |
| Number Of Beneficiaries Age 65 to 74 | 1455 |
| Number Of Beneficiaries Age 75 to 84 | 902 |
| Number Of Beneficiaries Age Greater 84 | 420 |
| Number Of Female Beneficiaries | 1976 |
| Number Of Male Beneficiaries | 1349 |
| Number Of Non Hispanic White Beneficiaries | 2936 |
| Number Of Black or African American Beneficiaries | 121 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 140 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 75 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2596 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 729 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 69 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.4031 |