| National Provider Identifier [NPI]: | 1578609830 |
| 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 | 700 W IRONWOOD DR |
| Street Address 2 Of The Provider | SUITE 336 |
| City Of The Provider | COEUR D ALENE |
| Zip Code Of The Provider | 838142656 |
| State Code Of The Provider | ID |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 40 |
| Number Of Services | 3409 |
| Number Of Medicare Beneficiaries | 651 |
| Total Submitted Charge Amount | 523473.5 |
| Total Medicare Allowed Amount | 267593.88 |
| Total Medicare Payment Amount | 200816.79 |
| Total Medicare Standardized Payment Amount | 217957.9 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 569 |
| Number Of Medicare Beneficiaries With Drug Services | 58 |
| Total Drug Submitted ChargeAmount | 1151.5 |
| Total Drug Medicare AllowedAmount | 866.08 |
| Total Drug Medicare PaymentAmount | 763.54 |
| Total Drug Medicare Standardized Payment Amount | 763.54 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 37 |
| Number Of Medical Services | 2840 |
| Number Of Medicare Beneficiaries With Medical Services | 651 |
| Total Medical Submitted Charge Amount | 522322 |
| Total Medical Medicare Allowed Amount | 266727.8 |
| Total Medical Medicare Payment Amount | 200053.25 |
| Total Medical Medicare Standardized Payment Amount | 217194.36 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 108 |
| Number Of Beneficiaries Age 65 to 74 | 284 |
| Number Of Beneficiaries Age 75 to 84 | 198 |
| Number Of Beneficiaries Age Greater 84 | 61 |
| Number Of Female Beneficiaries | 333 |
| Number Of Male Beneficiaries | 318 |
| Number Of Non Hispanic White Beneficiaries | 614 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 11 |
| Number Of American Indian Alaska Native Beneficiaries | 12 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 481 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 170 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 62 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.7667 |