| National Provider Identifier [NPI]: | 1821033861 |
| Last Name Of The Provider | TEKAUTZ |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1524 MCHENRY AVE |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | MODESTO |
| Zip Code Of The Provider | 953504500 |
| 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 | 153 |
| Number Of Services | 6306 |
| Number Of Medicare Beneficiaries | 2345 |
| Total Submitted Charge Amount | 820948 |
| Total Medicare Allowed Amount | 150934.44 |
| Total Medicare Payment Amount | 112790.69 |
| Total Medicare Standardized Payment Amount | 107905.83 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 2778 |
| Number Of Medicare Beneficiaries With Drug Services | 54 |
| Total Drug Submitted ChargeAmount | 3192 |
| Total Drug Medicare AllowedAmount | 546.7 |
| Total Drug Medicare PaymentAmount | 423.73 |
| Total Drug Medicare Standardized Payment Amount | 423.73 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 150 |
| Number Of Medical Services | 3528 |
| Number Of Medicare Beneficiaries With Medical Services | 2345 |
| Total Medical Submitted Charge Amount | 817756 |
| Total Medical Medicare Allowed Amount | 150387.74 |
| Total Medical Medicare Payment Amount | 112366.96 |
| Total Medical Medicare Standardized Payment Amount | 107482.1 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 505 |
| Number Of Beneficiaries Age 65 to 74 | 814 |
| Number Of Beneficiaries Age 75 to 84 | 687 |
| Number Of Beneficiaries Age Greater 84 | 339 |
| Number Of Female Beneficiaries | 1276 |
| Number Of Male Beneficiaries | 1069 |
| Number Of Non Hispanic White Beneficiaries | 1579 |
| Number Of Black or African American Beneficiaries | 58 |
| Number Of AsianPacific Islander Beneficiaries | 115 |
| Number Of Hispanic Beneficiaries | 544 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1108 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1237 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 46 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 50 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 58 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.8827 |