| National Provider Identifier [NPI]: | 1558361048 |
| Last Name Of The Provider | CHANG |
| First Name Of The Provider | FONG |
| 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 | 5307 MAIN ST |
| Street Address 2 Of The Provider | SUITE 102 |
| City Of The Provider | NEW PORT RICHEY |
| Zip Code Of The Provider | 346522536 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 51 |
| Number Of Services | 7290 |
| Number Of Medicare Beneficiaries | 665 |
| Total Submitted Charge Amount | 528594.98 |
| Total Medicare Allowed Amount | 350187.79 |
| Total Medicare Payment Amount | 262989.68 |
| Total Medicare Standardized Payment Amount | 265893.7 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 2623 |
| Number Of Medicare Beneficiaries With Drug Services | 73 |
| Total Drug Submitted ChargeAmount | 10190.98 |
| Total Drug Medicare AllowedAmount | 7765.87 |
| Total Drug Medicare PaymentAmount | 6130.64 |
| Total Drug Medicare Standardized Payment Amount | 6130.64 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 47 |
| Number Of Medical Services | 4667 |
| Number Of Medicare Beneficiaries With Medical Services | 665 |
| Total Medical Submitted Charge Amount | 518404 |
| Total Medical Medicare Allowed Amount | 342421.92 |
| Total Medical Medicare Payment Amount | 256859.04 |
| Total Medical Medicare Standardized Payment Amount | 259763.06 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 33 |
| Number Of Beneficiaries Age 65 to 74 | 197 |
| Number Of Beneficiaries Age 75 to 84 | 259 |
| Number Of Beneficiaries Age Greater 84 | 176 |
| Number Of Female Beneficiaries | 366 |
| Number Of Male Beneficiaries | 299 |
| Number Of Non Hispanic White Beneficiaries | 615 |
| Number Of Black or African American Beneficiaries | 14 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 25 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 615 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 50 |
| Percent Of With Atrial Fibrillation | 33 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.7034 |