| National Provider Identifier [NPI]: | 1295833259 |
| Last Name Of The Provider | PALACIO-CHANG |
| First Name Of The Provider | ADORACION |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 39880 VAN DYKE AVE |
| Street Address 2 Of The Provider | SUITE 203 |
| City Of The Provider | STERLING HEIGHTS |
| Zip Code Of The Provider | 483134668 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 11 |
| Number Of Services | 211 |
| Number Of Medicare Beneficiaries | 29 |
| Total Submitted Charge Amount | 22075 |
| Total Medicare Allowed Amount | 12825.52 |
| Total Medicare Payment Amount | 9824.2 |
| Total Medicare Standardized Payment Amount | 9874.76 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 15 |
| Number Of Medicare Beneficiaries With Drug Services | 15 |
| Total Drug Submitted ChargeAmount | 570 |
| Total Drug Medicare AllowedAmount | 283.8 |
| Total Drug Medicare PaymentAmount | 278.1 |
| Total Drug Medicare Standardized Payment Amount | 278.1 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 10 |
| Number Of Medical Services | 196 |
| Number Of Medicare Beneficiaries With Medical Services | 29 |
| Total Medical Submitted Charge Amount | 21505 |
| Total Medical Medicare Allowed Amount | 12541.72 |
| Total Medical Medicare Payment Amount | 9546.1 |
| Total Medical Medicare Standardized Payment Amount | 9596.66 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 0 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | 14 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 18 |
| Number Of Male Beneficiaries | 11 |
| Number Of Non Hispanic White Beneficiaries | 11 |
| Number Of Black or African American Beneficiaries | 0 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 0 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | |
| Percent Of With Diabetes | |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 0 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0318 |