| National Provider Identifier [NPI]: | 1942464649 |
| Last Name Of The Provider | COSTA |
| First Name Of The Provider | MATTHEW |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 300 COMMUNITY DR |
| Street Address 2 Of The Provider | CARDIOLOGY DEPT |
| City Of The Provider | MANHASSET |
| Zip Code Of The Provider | 110303816 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 109 |
| Number Of Services | 6794 |
| Number Of Medicare Beneficiaries | 1400 |
| Total Submitted Charge Amount | 1437482 |
| Total Medicare Allowed Amount | 454680.19 |
| Total Medicare Payment Amount | 342082.45 |
| Total Medicare Standardized Payment Amount | 335307.86 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 380 |
| Number Of Medicare Beneficiaries With Drug Services | 91 |
| Total Drug Submitted ChargeAmount | 47736 |
| Total Drug Medicare AllowedAmount | 15749.4 |
| Total Drug Medicare PaymentAmount | 12418.88 |
| Total Drug Medicare Standardized Payment Amount | 12418.88 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 101 |
| Number Of Medical Services | 6414 |
| Number Of Medicare Beneficiaries With Medical Services | 1400 |
| Total Medical Submitted Charge Amount | 1389746 |
| Total Medical Medicare Allowed Amount | 438930.79 |
| Total Medical Medicare Payment Amount | 329663.57 |
| Total Medical Medicare Standardized Payment Amount | 322888.98 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 170 |
| Number Of Beneficiaries Age 65 to 74 | 467 |
| Number Of Beneficiaries Age 75 to 84 | 423 |
| Number Of Beneficiaries Age Greater 84 | 340 |
| Number Of Female Beneficiaries | 782 |
| Number Of Male Beneficiaries | 618 |
| Number Of Non Hispanic White Beneficiaries | 1231 |
| Number Of Black or African American Beneficiaries | 38 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 87 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 33 |
| Number Of Beneficiaries With Medicare Only Entitlement | 971 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 429 |
| Percent Of With Atrial Fibrillation | 29 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 41 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.8036 |