| National Provider Identifier [NPI]: | 1649484080 |
| Last Name Of The Provider | MOTTA |
| First Name Of The Provider | ANGELICA |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 755 N 11TH ST |
| Street Address 2 Of The Provider | SUITE P2200 |
| City Of The Provider | BEAUMONT |
| Zip Code Of The Provider | 777021500 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 123 |
| Number Of Services | 12260 |
| Number Of Medicare Beneficiaries | 1907 |
| Total Submitted Charge Amount | 3380794.54 |
| Total Medicare Allowed Amount | 693592 |
| Total Medicare Payment Amount | 524205.02 |
| Total Medicare Standardized Payment Amount | 552194.49 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 6880 |
| Number Of Medicare Beneficiaries With Drug Services | 157 |
| Total Drug Submitted ChargeAmount | 53822 |
| Total Drug Medicare AllowedAmount | 3112.5 |
| Total Drug Medicare PaymentAmount | 2425.04 |
| Total Drug Medicare Standardized Payment Amount | 2425.04 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 119 |
| Number Of Medical Services | 5380 |
| Number Of Medicare Beneficiaries With Medical Services | 1907 |
| Total Medical Submitted Charge Amount | 3326972.54 |
| Total Medical Medicare Allowed Amount | 690479.5 |
| Total Medical Medicare Payment Amount | 521779.98 |
| Total Medical Medicare Standardized Payment Amount | 549769.45 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 219 |
| Number Of Beneficiaries Age 65 to 74 | 675 |
| Number Of Beneficiaries Age 75 to 84 | 682 |
| Number Of Beneficiaries Age Greater 84 | 331 |
| Number Of Female Beneficiaries | 1109 |
| Number Of Male Beneficiaries | 798 |
| Number Of Non Hispanic White Beneficiaries | 1600 |
| Number Of Black or African American Beneficiaries | 252 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 40 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1531 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 376 |
| Percent Of With Atrial Fibrillation | 25 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 52 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 71 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 1.7753 |