| National Provider Identifier [NPI]: | 1679527642 |
| Last Name Of The Provider | ANGTUACO |
| First Name Of The Provider | EDWARD |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9601 LILE DRIVE - SUITE 1100 |
| Street Address 2 Of The Provider | |
| City Of The Provider | LITTLE ROCK |
| Zip Code Of The Provider | 722056333 |
| 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 | 176 |
| Number Of Services | 6901 |
| Number Of Medicare Beneficiaries | 4159 |
| Total Submitted Charge Amount | 831275 |
| Total Medicare Allowed Amount | 219869.4 |
| Total Medicare Payment Amount | 167509.81 |
| Total Medicare Standardized Payment Amount | 181504.06 |
| 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 | 176 |
| Number Of Medical Services | 6901 |
| Number Of Medicare Beneficiaries With Medical Services | 4159 |
| Total Medical Submitted Charge Amount | 831275 |
| Total Medical Medicare Allowed Amount | 219869.4 |
| Total Medical Medicare Payment Amount | 167509.81 |
| Total Medical Medicare Standardized Payment Amount | 181504.06 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 961 |
| Number Of Beneficiaries Age 65 to 74 | 1595 |
| Number Of Beneficiaries Age 75 to 84 | 1144 |
| Number Of Beneficiaries Age Greater 84 | 459 |
| Number Of Female Beneficiaries | 2682 |
| Number Of Male Beneficiaries | 1477 |
| Number Of Non Hispanic White Beneficiaries | 2888 |
| Number Of Black or African American Beneficiaries | 1228 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 22 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2849 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1310 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.4046 |