| National Provider Identifier [NPI]: | 1467412445 |
| Last Name Of The Provider | CHANG |
| First Name Of The Provider | PATRICIA |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 347 SMITH AVE N |
| Street Address 2 Of The Provider | SUITE 203 |
| City Of The Provider | SAINT PAUL |
| Zip Code Of The Provider | 551022387 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Obstetrics/Gynecology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 38 |
| Number Of Services | 173 |
| Number Of Medicare Beneficiaries | 65 |
| Total Submitted Charge Amount | 38622 |
| Total Medicare Allowed Amount | 14313.86 |
| Total Medicare Payment Amount | 10475.04 |
| Total Medicare Standardized Payment Amount | 11293.63 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 11 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 567 |
| Total Drug Medicare AllowedAmount | 356.99 |
| Total Drug Medicare PaymentAmount | 349.84 |
| Total Drug Medicare Standardized Payment Amount | 349.84 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 34 |
| Number Of Medical Services | 162 |
| Number Of Medicare Beneficiaries With Medical Services | 65 |
| Total Medical Submitted Charge Amount | 38055 |
| Total Medical Medicare Allowed Amount | 13956.87 |
| Total Medical Medicare Payment Amount | 10125.2 |
| Total Medical Medicare Standardized Payment Amount | 10943.79 |
| Average Age Of Beneficiaries | 61 |
| Number Of Beneficiaries Age Less65 | 28 |
| Number Of Beneficiaries Age 65 to 74 | 21 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 65 |
| Number Of Male Beneficiaries | 0 |
| Number Of Non Hispanic White Beneficiaries | 49 |
| Number Of Black or African American Beneficiaries | |
| 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 | 0 |
| Number Of Beneficiaries With Medicare Only Entitlement | 41 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 24 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 0 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 0 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 26 |
| Percent Of With Hypertension | 43 |
| Percent Of With Ischemic Heart Disease | |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 28 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2364 |