| National Provider Identifier [NPI]: | 1033271630 |
| Last Name Of The Provider | KOSTAL |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 252 CHAPMAN RD |
| Street Address 2 Of The Provider | SUITE 150 |
| City Of The Provider | NEWARK |
| Zip Code Of The Provider | 197025436 |
| State Code Of The Provider | DE |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 40 |
| Number Of Services | 3896 |
| Number Of Medicare Beneficiaries | 1958 |
| Total Submitted Charge Amount | 1173821.68 |
| Total Medicare Allowed Amount | 199362.7 |
| Total Medicare Payment Amount | 150315 |
| Total Medicare Standardized Payment Amount | 148537.58 |
| 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 | 40 |
| Number Of Medical Services | 3896 |
| Number Of Medicare Beneficiaries With Medical Services | 1958 |
| Total Medical Submitted Charge Amount | 1173821.68 |
| Total Medical Medicare Allowed Amount | 199362.7 |
| Total Medical Medicare Payment Amount | 150315 |
| Total Medical Medicare Standardized Payment Amount | 148537.58 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 231 |
| Number Of Beneficiaries Age 65 to 74 | 721 |
| Number Of Beneficiaries Age 75 to 84 | 637 |
| Number Of Beneficiaries Age Greater 84 | 369 |
| Number Of Female Beneficiaries | 1026 |
| Number Of Male Beneficiaries | 932 |
| Number Of Non Hispanic White Beneficiaries | 1564 |
| Number Of Black or African American Beneficiaries | 309 |
| Number Of AsianPacific Islander Beneficiaries | 33 |
| Number Of Hispanic Beneficiaries | 32 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 20 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1678 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 280 |
| Percent Of With Atrial Fibrillation | 35 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 64 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 1.7635 |