| National Provider Identifier [NPI]: | 1720362254 |
| Last Name Of The Provider | COSTABILE |
| First Name Of The Provider | JAMES |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4825 W TILGHMAN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | ALLENTOWN |
| Zip Code Of The Provider | 181049322 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 33 |
| Number Of Services | 611 |
| Number Of Medicare Beneficiaries | 256 |
| Total Submitted Charge Amount | 90601 |
| Total Medicare Allowed Amount | 29586.56 |
| Total Medicare Payment Amount | 18924.69 |
| Total Medicare Standardized Payment Amount | 24468.49 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 44 |
| Number Of Medicare Beneficiaries With Drug Services | 22 |
| Total Drug Submitted ChargeAmount | 831 |
| Total Drug Medicare AllowedAmount | 373.28 |
| Total Drug Medicare PaymentAmount | 331.98 |
| Total Drug Medicare Standardized Payment Amount | 331.98 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 24 |
| Number Of Medical Services | 567 |
| Number Of Medicare Beneficiaries With Medical Services | 256 |
| Total Medical Submitted Charge Amount | 89770 |
| Total Medical Medicare Allowed Amount | 29213.28 |
| Total Medical Medicare Payment Amount | 18592.71 |
| Total Medical Medicare Standardized Payment Amount | 24136.51 |
| Average Age Of Beneficiaries | 58 |
| Number Of Beneficiaries Age Less65 | 175 |
| Number Of Beneficiaries Age 65 to 74 | 47 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 157 |
| Number Of Male Beneficiaries | 99 |
| Number Of Non Hispanic White Beneficiaries | 196 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 34 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 124 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 132 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 54 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 21 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2517 |