Patrick Costello, MD
Emergency Medicine · Council Bluffs, IANPI 1952415150
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 100.0% of the total across 55 separate payments, which is the pattern of a clinician who attends manufacturer presentations rather than one with a consulting arrangement. AbbVie accounts for 79.8% of it on its own, with 4 other manufacturers making up the rest. Among emergency medicine clinicians in IA with any reported payments, this total sits in the top 5% — high for the specialty, which is a reason to read the composition above rather than the number alone.
Across 55 payments — averaging $15.88 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- AbbVie$697
- Melinta Therapeutics, LLC$94
- Smith+Nephew$37
- Kowa Pharmaceuticals America, Inc.$28
- Johnson & Johnson$16
What the payments were for
- Food & beverage$873100%
Most of this is food and beverage — typically meals provided during product presentations at a clinic or hospital. Nationally that is the single largest category of reported payments by count.
General payments by program year
Who reported the general payments
Companies are grouped under their corporate parent — a single manufacturer often files under several CMS reporting entities. Research and ownership payments are counted separately and are not in this table.
| Company | Payments | Total |
|---|---|---|
| AbbVie | 45 | $697 |
| Melinta Therapeutics, LLC | 5 | $94 |
| Smith+Nephew | 2 | $37 |
| Kowa Pharmaceuticals America, Inc. | 2 | $28 |
| Johnson & Johnson | 1 | $16 |
How this compares
$873 in reported general payments places this provider in the 95th percentile of 360 emergency medicine providers in Iowa.
Medicare billing
What this is not: this is the amount Original Medicare Part B allowed for services this provider billed in 2024. It is not their income. It excludes Medicare Advantage — now more than half of all Medicare enrollment — along with Medicaid and all commercial insurance, and it is gross practice revenue before staff, rent, supplies and malpractice premiums. CMS also suppresses any figure covering ten or fewer patients, so low-volume providers appear smaller than they are.
Most prescribed under Part D
| Drug | Claims | Cost to plans & patients |
|---|---|---|
| Albuterol Sulfate HfaAlbuterol Sulfate | 13 | $303 |
| Hydrocodone-AcetaminophenHydrocodone/Acetaminophen | 59 | $233 |
| Doxycycline Hyclate | 20 | $171 |
| Ondansetron OdtOndansetron | 27 | $151 |
| Ciprofloxacin Hcl | 32 | $145 |
| Sulfamethoxazole-TrimethoprimSulfamethoxazole/Trimethoprim | 27 | $142 |
| Cephalexin | 13 | $79 |
| Oxycodone-AcetaminophenOxycodone Hcl/Acetaminophen | 13 | $47 |
| Cyclobenzaprine Hcl | 12 | $40 |
| Prednisone | 20 | $35 |
| Tramadol Hcl | 17 | $28 |
Paid to pharmacies, not to this prescriber.
Other emergency medicine in Council Bluffs
- Thomas CheatleCouncil Bluffs$934
- Anthony CarterCedar Rapids$408K
- Thomas WernimontAmes$134K
- David TalanIowa City$48K
- Hijinio CarreonDes Moines$25K
- Todd SextonDes Moines$5K
- Philip SpanheimerIowa City$5K
- Scott MurraySioux City$5K
- Mohammad KotobIowa City$3K
- Ryan BakkeNewton$3K
Where these figures come from
- Payments: CMS Open Payments, program years 2019–2025 (publication P06302026_06032026).
- Billing: Medicare Physician & Other Practitioners, data year 2024. Original Medicare Part B only.
- Identity: NPPES NPI Registry, July 2026.