| National Provider Identifier [NPI]: | 1104987635 |
| Last Name Of The Provider | COST |
| First Name Of The Provider | GREGORY |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 19250 SW 65TH AVE |
| Street Address 2 Of The Provider | SUITE 235 |
| City Of The Provider | TUALATIN |
| Zip Code Of The Provider | 970627452 |
| State Code Of The Provider | OR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 84 |
| Number Of Services | 4031 |
| Number Of Medicare Beneficiaries | 431 |
| Total Submitted Charge Amount | 567527.12 |
| Total Medicare Allowed Amount | 242865.93 |
| Total Medicare Payment Amount | 178602.74 |
| Total Medicare Standardized Payment Amount | 179412.51 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 1455 |
| Number Of Medicare Beneficiaries With Drug Services | 58 |
| Total Drug Submitted ChargeAmount | 63924.12 |
| Total Drug Medicare AllowedAmount | 46487.87 |
| Total Drug Medicare PaymentAmount | 35385.36 |
| Total Drug Medicare Standardized Payment Amount | 35385.36 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 74 |
| Number Of Medical Services | 2576 |
| Number Of Medicare Beneficiaries With Medical Services | 431 |
| Total Medical Submitted Charge Amount | 503603 |
| Total Medical Medicare Allowed Amount | 196378.06 |
| Total Medical Medicare Payment Amount | 143217.38 |
| Total Medical Medicare Standardized Payment Amount | 144027.15 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 38 |
| Number Of Beneficiaries Age 65 to 74 | 180 |
| Number Of Beneficiaries Age 75 to 84 | 131 |
| Number Of Beneficiaries Age Greater 84 | 82 |
| Number Of Female Beneficiaries | 100 |
| Number Of Male Beneficiaries | 331 |
| Number Of Non Hispanic White Beneficiaries | 394 |
| Number Of Black or African American Beneficiaries | 18 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 378 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 53 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 30 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.2684 |