| National Provider Identifier [NPI]: | 1912250101 |
| Last Name Of The Provider | KOSTA |
| First Name Of The Provider | MEGAN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | FNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1020 DENNISON AVE |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | COLUMBUS |
| Zip Code Of The Provider | 432013497 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 33 |
| Number Of Services | 762 |
| Number Of Medicare Beneficiaries | 201 |
| Total Submitted Charge Amount | 55141 |
| Total Medicare Allowed Amount | 32374.35 |
| Total Medicare Payment Amount | 22829.38 |
| Total Medicare Standardized Payment Amount | 28564.27 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 41 |
| Number Of Medicare Beneficiaries With Drug Services | 39 |
| Total Drug Submitted ChargeAmount | 890 |
| Total Drug Medicare AllowedAmount | 414.01 |
| Total Drug Medicare PaymentAmount | 405.48 |
| Total Drug Medicare Standardized Payment Amount | 405.48 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 27 |
| Number Of Medical Services | 721 |
| Number Of Medicare Beneficiaries With Medical Services | 201 |
| Total Medical Submitted Charge Amount | 54251 |
| Total Medical Medicare Allowed Amount | 31960.34 |
| Total Medical Medicare Payment Amount | 22423.9 |
| Total Medical Medicare Standardized Payment Amount | 28158.79 |
| Average Age Of Beneficiaries | 49 |
| Number Of Beneficiaries Age Less65 | 174 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 111 |
| Number Of Male Beneficiaries | 90 |
| Number Of Non Hispanic White Beneficiaries | 109 |
| Number Of Black or African American Beneficiaries | 81 |
| 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 | 17 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 184 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 19 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 7 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 49 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 54 |
| Percent Of With Ischemic Heart Disease | 15 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 25 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 42 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1917 |