| National Provider Identifier [NPI]: | 1528041621 |
| Last Name Of The Provider | CHANG |
| First Name Of The Provider | SALLY |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 407 ULUNIU ST STE 313 |
| Street Address 2 Of The Provider | |
| City Of The Provider | KAILUA |
| Zip Code Of The Provider | 967342544 |
| State Code Of The Provider | HI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 22 |
| Number Of Services | 3264 |
| Number Of Medicare Beneficiaries | 179 |
| Total Submitted Charge Amount | 191186.78 |
| Total Medicare Allowed Amount | 134705.25 |
| Total Medicare Payment Amount | 104731.98 |
| Total Medicare Standardized Payment Amount | 99243.97 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 141 |
| Number Of Medicare Beneficiaries With Drug Services | 137 |
| Total Drug Submitted ChargeAmount | 6952 |
| Total Drug Medicare AllowedAmount | 4667.95 |
| Total Drug Medicare PaymentAmount | 4574.24 |
| Total Drug Medicare Standardized Payment Amount | 4574.24 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 19 |
| Number Of Medical Services | 3123 |
| Number Of Medicare Beneficiaries With Medical Services | 179 |
| Total Medical Submitted Charge Amount | 184234.78 |
| Total Medical Medicare Allowed Amount | 130037.3 |
| Total Medical Medicare Payment Amount | 100157.74 |
| Total Medical Medicare Standardized Payment Amount | 94669.73 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 71 |
| Number Of Beneficiaries Age 75 to 84 | 74 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 127 |
| Number Of Male Beneficiaries | 52 |
| Number Of Non Hispanic White Beneficiaries | 42 |
| Number Of Black or African American Beneficiaries | 0 |
| Number Of AsianPacific Islander Beneficiaries | 105 |
| Number Of Hispanic Beneficiaries | 0 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 32 |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 6 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 26 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.055 |