| National Provider Identifier [NPI]: | 1962766337 | 
| Last Name Of The Provider | CHANG | 
| First Name Of The Provider | TIMOTHY | 
| Middle Initial Of The Provider | W | 
| Credentials Of The Provider | MD | 
| Gender Of The Provider | M | 
| Entity Type Of The Provider | I | 
| Street Address 1 Of The Provider | 200 1ST ST SW | 
| Street Address 2 Of The Provider | |
| City Of The Provider | ROCHESTER | 
| Zip Code Of The Provider | 559050001 | 
| State Code Of The Provider | MN | 
| Country Code Of The Provider | US | 
| Provider Type Of The Provider | Dermatology | 
| Medicare Participation Indicator | Y | 
| Number Of HCPCS | 19 | 
| Number Of Services | 863 | 
| Number Of Medicare Beneficiaries | 219 | 
| Total Submitted Charge Amount | 43511.88 | 
| Total Medicare Allowed Amount | 37031.35 | 
| Total Medicare Payment Amount | 27960.08 | 
| Total Medicare Standardized Payment Amount | 29155.56 | 
| Drug Suppress Indicator | * | 
| Number Of HCPCS Associated With Drug Services | |
| Number Of Drug Services | |
| Number Of Medicare Beneficiaries With Drug Services | |
| Total Drug Submitted ChargeAmount | |
| Total Drug Medicare AllowedAmount | |
| Total Drug Medicare PaymentAmount | |
| Total Drug Medicare Standardized Payment Amount | |
| Medical SuppressIndicator | # | 
| Number Of HCPCS Associated With MedicalServices | |
| Number Of Medical Services | |
| Number Of Medicare Beneficiaries With Medical Services | |
| Total Medical Submitted Charge Amount | |
| Total Medical Medicare Allowed Amount | |
| Total Medical Medicare Payment Amount | |
| Total Medical Medicare Standardized Payment Amount | |
| Average Age Of Beneficiaries | 75 | 
| Number Of Beneficiaries Age Less65 | 17 | 
| Number Of Beneficiaries Age 65 to 74 | 81 | 
| Number Of Beneficiaries Age 75 to 84 | 96 | 
| Number Of Beneficiaries Age Greater 84 | 25 | 
| Number Of Female Beneficiaries | 88 | 
| Number Of Male Beneficiaries | 131 | 
| Number Of Non Hispanic White Beneficiaries | 208 | 
| Number Of Black or African American Beneficiaries | 0 | 
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 11 | 
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 6 | 
| Percent Of With Cancer | 11 | 
| Percent Of With Heart Failure | 11 | 
| Percent Of With Chronic Kidney Disease | 15 | 
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 | 
| Percent Of With Depression | 17 | 
| Percent Of With Diabetes | 21 | 
| Percent Of With Hyperlipidemia | 38 | 
| Percent Of With Hypertension | 42 | 
| Percent Of With Ischemic Heart Disease | 36 | 
| Percent Of With Osteoporosis | 5 | 
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 | 
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0343 |