| National Provider Identifier [NPI]: | 1386725042 |
| Last Name Of The Provider | ANGTUACO |
| First Name Of The Provider | TERESITA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4301 W MARKHAM ST # 783 |
| Street Address 2 Of The Provider | |
| City Of The Provider | LITTLE ROCK |
| Zip Code Of The Provider | 722057101 |
| State Code Of The Provider | AR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 116 |
| Number Of Services | 4484 |
| Number Of Medicare Beneficiaries | 2685 |
| Total Submitted Charge Amount | 302494 |
| Total Medicare Allowed Amount | 111675.19 |
| Total Medicare Payment Amount | 81931.29 |
| Total Medicare Standardized Payment Amount | 88231.79 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 116 |
| Number Of Medical Services | 4484 |
| Number Of Medicare Beneficiaries With Medical Services | 2685 |
| Total Medical Submitted Charge Amount | 302494 |
| Total Medical Medicare Allowed Amount | 111675.19 |
| Total Medical Medicare Payment Amount | 81931.29 |
| Total Medical Medicare Standardized Payment Amount | 88231.79 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 976 |
| Number Of Beneficiaries Age 65 to 74 | 906 |
| Number Of Beneficiaries Age 75 to 84 | 574 |
| Number Of Beneficiaries Age Greater 84 | 229 |
| Number Of Female Beneficiaries | 1494 |
| Number Of Male Beneficiaries | 1191 |
| Number Of Non Hispanic White Beneficiaries | 1944 |
| Number Of Black or African American Beneficiaries | 672 |
| Number Of AsianPacific Islander Beneficiaries | 12 |
| Number Of Hispanic Beneficiaries | 37 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1678 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1007 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 47 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 14 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 2.1042 |