Racquel Anel-Tiangco, MD
Endocrinology, Diabetes & Metabolism · Sioux Falls, SDNPI 1740462803
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 100.0% of the total across 21 separate payments, which is the pattern of a clinician who attends manufacturer presentations rather than one with a consulting arrangement. 13 manufacturers reported payments, led by Novo Nordisk at 27.7% of the total. 2025 is the largest year on record at $261, 5.4 times the $48 reported in 2019. That places this record below the midpoint for endocrinology, diabetes & metabolism clinicians in SD, where the typical reported total is $921.
Across 21 payments — averaging $24.10 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Novo Nordisk$140
- Amgen$106
- Pfizer$54
- Novartis$45
- Radius Health, Inc.$25
- Chiesi USA, Inc.$23
- plus $113 from 7 others
What the payments were for
- Food & beverage$506100%
Most of this is food and beverage — typically meals provided during product presentations at a clinic or hospital. Nationally that is the single largest category of reported payments by count.
General payments by program year
Who reported the general payments
Companies are grouped under their corporate parent — a single manufacturer often files under several CMS reporting entities. Research and ownership payments are counted separately and are not in this table.
| Company | Payments | Total |
|---|---|---|
| Novo Nordisk | 2 | $140 |
| Amgen | 5 | $106 |
| Pfizer | 3 | $54 |
| Novartis | 2 | $45 |
| Radius Health, Inc. | 1 | $25 |
| Chiesi USA, Inc. | 1 | $23 |
| Dexcom, Inc. | 1 | $23 |
| Kyowa Kirin, Inc. | 1 | $19 |
| Ascendis Pharma Endocrinology Inc | 1 | $16 |
| Sanofi-aventis U.S. LLC | 1 | $16 |
| Tandem Diabetes Care, Inc. | 1 | $15 |
| Medtronic | 1 | $14 |
| Johnson & Johnson | 1 | $11 |
What the payments were tied to
Products named in the reported payments. Only payments of $100 or more are attributed here — the typical reported payment nationally is a meal worth about $16, and listing those product-by-product would be noise.
- RYBELSUS$124
How this compares
$506 in reported general payments places this provider in the 35th percentile of 20 endocrinology, diabetes & metabolism providers in South Dakota.
See all endocrinology, diabetes & metabolism providers in South Dakota →
Medicare billing
What this is not: this is the amount Original Medicare Part B allowed for services this provider billed in 2024. It is not their income. It excludes Medicare Advantage — now more than half of all Medicare enrollment — along with Medicaid and all commercial insurance, and it is gross practice revenue before staff, rent, supplies and malpractice premiums. CMS also suppresses any figure covering ten or fewer patients, so low-volume providers appear smaller than they are.
Most prescribed under Part D
| Drug | Claims | Cost to plans & patients |
|---|---|---|
| MounjaroTirzepatide | 102 | $110,261 |
| OzempicSemaglutide | 76 | $75,056 |
| JardianceEmpagliflozin | 74 | $67,770 |
| TrulicityDulaglutide | 32 | $30,430 |
| Teriparatide | 11 | $26,786 |
| Fiasp FlextouchInsulin Aspart (Niacinamide) | 34 | $26,075 |
| Tresiba Flextouch U-100Insulin Degludec | 40 | $17,539 |
| Repatha SureclickEvolocumab | 27 | $16,039 |
| VascepaIcosapent Ethyl | 28 | $14,814 |
| Basaglar Kwikpen U-100Insulin Glargine,hum.Rec.Anlog | 29 | $14,706 |
| Novolog FlexpenInsulin Aspart | 63 | $13,868 |
| SynthroidLevothyroxine Sodium | 150 | $12,854 |
| Omnipod 5 Dexg7g6 Pods (Gen 5)Insulin Pump Cart,auto,bt,g6/7 | 25 | $12,389 |
| Humulin R U-500 KwikpenInsulin Regular, Human | 14 | $11,515 |
| Toujeo Max SolostarInsulin Glargine,hum.Rec.Anlog | 19 | $11,310 |
Paid to pharmacies, not to this prescriber.
Companies that both paid and supply prescribed drugs
These companies both reported payments to this provider and make drugs the provider prescribed under Medicare Part D in 2024. For most specialties this overlap is expected — a cardiologist who is paid by a cardiology drugmaker also treats heart disease. It is shown so the reader can see it, not because it implies anything on its own.
| Company | Paid to this provider | Part D cost of their drugs |
|---|---|---|
| Novo NordiskOzempic, Fiasp, Novolog | $140 | $94,291126 claims |
| PfizerLevoxyl | $54 | $93220 claims |
Reading this fairly. The Part D column is what drug plans and patients paid pharmacies — this provider received none of it, and it reflects how many patients they treat and what those drugs cost. Against peers, this provider's reported payments sit in the 35th percentile of 20 endocrinology, diabetes & metabolism providers in South Dakota.
Other endocrinology, diabetes & metabolism in Sioux Falls
- Richard CrawfordSioux Falls$126K
- Brandon AllardSioux Falls$3K
- Randall FennerSioux Falls$2K
- Marie Angelica DiazSioux Falls$2K
- Hassan MehmoodSioux Falls$1K
- Lorayne ChuaSioux Falls$1K
- Marcio GriebelerSioux Falls$1K
- Anthony SallarSioux Falls$921
- Nour Aljariri AlhesanSioux Falls$558
- Natalie KappusSioux Falls$526
Where these figures come from
- Payments: CMS Open Payments, program years 2019–2025 (publication P06302026_06032026).
- Billing: Medicare Physician & Other Practitioners, data year 2024. Original Medicare Part B only.
- Identity: NPPES NPI Registry, July 2026.