| National Provider Identifier [NPI]: | 1568451284 |
| Last Name Of The Provider | CHANG |
| First Name Of The Provider | STEPHEN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6424 E BROADWAY RD |
| Street Address 2 Of The Provider | STE 101 |
| City Of The Provider | MESA |
| Zip Code Of The Provider | 852061750 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 220 |
| Number Of Services | 14952 |
| Number Of Medicare Beneficiaries | 3259 |
| Total Submitted Charge Amount | 1468619.18 |
| Total Medicare Allowed Amount | 405761.14 |
| Total Medicare Payment Amount | 304822.44 |
| Total Medicare Standardized Payment Amount | 313133.11 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 10227 |
| Number Of Medicare Beneficiaries With Drug Services | 137 |
| Total Drug Submitted ChargeAmount | 16246.68 |
| Total Drug Medicare AllowedAmount | 3437.18 |
| Total Drug Medicare PaymentAmount | 2591.48 |
| Total Drug Medicare Standardized Payment Amount | 2591.48 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 213 |
| Number Of Medical Services | 4725 |
| Number Of Medicare Beneficiaries With Medical Services | 3259 |
| Total Medical Submitted Charge Amount | 1452372.5 |
| Total Medical Medicare Allowed Amount | 402323.96 |
| Total Medical Medicare Payment Amount | 302230.96 |
| Total Medical Medicare Standardized Payment Amount | 310541.63 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 336 |
| Number Of Beneficiaries Age 65 to 74 | 1296 |
| Number Of Beneficiaries Age 75 to 84 | 1038 |
| Number Of Beneficiaries Age Greater 84 | 589 |
| Number Of Female Beneficiaries | 1858 |
| Number Of Male Beneficiaries | 1401 |
| Number Of Non Hispanic White Beneficiaries | 2860 |
| Number Of Black or African American Beneficiaries | 86 |
| Number Of AsianPacific Islander Beneficiaries | 35 |
| Number Of Hispanic Beneficiaries | 171 |
| Number Of American Indian Alaska Native Beneficiaries | 75 |
| Number Of Beneficiaries With Race Not Else where Classified | 32 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2871 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 388 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 1.7634 |