| National Provider Identifier [NPI]: | 1487614145 |
| Last Name Of The Provider | COSTIN |
| First Name Of The Provider | KEVIN |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | P.A.-C |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 601 RIVERWAY PL UNIT 6 |
| Street Address 2 Of The Provider | |
| City Of The Provider | BEDFORD |
| Zip Code Of The Provider | 031106767 |
| State Code Of The Provider | NH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 8 |
| Number Of Services | 1351 |
| Number Of Medicare Beneficiaries | 165 |
| Total Submitted Charge Amount | 148815 |
| Total Medicare Allowed Amount | 104416.86 |
| Total Medicare Payment Amount | 74762.6 |
| Total Medicare Standardized Payment Amount | 73730.71 |
| 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 | 8 |
| Number Of Medical Services | 1351 |
| Number Of Medicare Beneficiaries With Medical Services | 165 |
| Total Medical Submitted Charge Amount | 148815 |
| Total Medical Medicare Allowed Amount | 104416.86 |
| Total Medical Medicare Payment Amount | 74762.6 |
| Total Medical Medicare Standardized Payment Amount | 73730.71 |
| Average Age Of Beneficiaries | 80 |
| Number Of Beneficiaries Age Less65 | 22 |
| Number Of Beneficiaries Age 65 to 74 | 36 |
| Number Of Beneficiaries Age 75 to 84 | 34 |
| Number Of Beneficiaries Age Greater 84 | 73 |
| Number Of Female Beneficiaries | 113 |
| Number Of Male Beneficiaries | 52 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 36 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 129 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 72 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 62 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 25 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 45 |
| Percent Of With Stroke | 22 |
| Average HCC Risk Score Of Beneficiaries | 2.1331 |