| National Provider Identifier [NPI]: | 1811948227 |
| Last Name Of The Provider | CHANG |
| First Name Of The Provider | JERRY |
| Middle Initial Of The Provider | Y |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 39000 BOB HOPE DR |
| Street Address 2 Of The Provider | EISENHOWER IMAGING CENTER |
| City Of The Provider | RANCHO MIRAGE |
| Zip Code Of The Provider | 922703221 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 263 |
| Number Of Services | 66705 |
| Number Of Medicare Beneficiaries | 2581 |
| Total Submitted Charge Amount | 3465762.25 |
| Total Medicare Allowed Amount | 907180.09 |
| Total Medicare Payment Amount | 697051.52 |
| Total Medicare Standardized Payment Amount | 685325.2 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 61444 |
| Number Of Medicare Beneficiaries With Drug Services | 743 |
| Total Drug Submitted ChargeAmount | 102968.64 |
| Total Drug Medicare AllowedAmount | 15688.47 |
| Total Drug Medicare PaymentAmount | 12266.47 |
| Total Drug Medicare Standardized Payment Amount | 12266.47 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 259 |
| Number Of Medical Services | 5261 |
| Number Of Medicare Beneficiaries With Medical Services | 2580 |
| Total Medical Submitted Charge Amount | 3362793.61 |
| Total Medical Medicare Allowed Amount | 891491.62 |
| Total Medical Medicare Payment Amount | 684785.05 |
| Total Medical Medicare Standardized Payment Amount | 673058.73 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 201 |
| Number Of Beneficiaries Age 65 to 74 | 915 |
| Number Of Beneficiaries Age 75 to 84 | 1003 |
| Number Of Beneficiaries Age Greater 84 | 462 |
| Number Of Female Beneficiaries | 1282 |
| Number Of Male Beneficiaries | 1299 |
| Number Of Non Hispanic White Beneficiaries | 2255 |
| Number Of Black or African American Beneficiaries | 29 |
| Number Of AsianPacific Islander Beneficiaries | 31 |
| Number Of Hispanic Beneficiaries | 231 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2244 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 337 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 22 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.9304 |