| National Provider Identifier [NPI]: | 1861537458 |
| Last Name Of The Provider | CHANG |
| First Name Of The Provider | TAM |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 456 PARK AVENUE |
| Street Address 2 Of The Provider | |
| City Of The Provider | WORCESTER |
| Zip Code Of The Provider | 016102473 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 21 |
| Number Of Services | 667 |
| Number Of Medicare Beneficiaries | 125 |
| Total Submitted Charge Amount | 97106.02 |
| Total Medicare Allowed Amount | 40104.71 |
| Total Medicare Payment Amount | 28412.26 |
| Total Medicare Standardized Payment Amount | 32553.29 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 121 |
| Number Of Medicare Beneficiaries With Drug Services | 66 |
| Total Drug Submitted ChargeAmount | 3641.02 |
| Total Drug Medicare AllowedAmount | 2023.11 |
| Total Drug Medicare PaymentAmount | 1955.85 |
| Total Drug Medicare Standardized Payment Amount | 1955.85 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 14 |
| Number Of Medical Services | 546 |
| Number Of Medicare Beneficiaries With Medical Services | 124 |
| Total Medical Submitted Charge Amount | 93465 |
| Total Medical Medicare Allowed Amount | 38081.6 |
| Total Medical Medicare Payment Amount | 26456.41 |
| Total Medical Medicare Standardized Payment Amount | 30597.44 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 50 |
| Number Of Beneficiaries Age 65 to 74 | 48 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 59 |
| Number Of Male Beneficiaries | 66 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 104 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 16 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 109 |
| 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 | |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 13 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 18 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8848 |