| National Provider Identifier [NPI]: | 1376711747 |
| Last Name Of The Provider | COSSIO |
| First Name Of The Provider | EDUARDO |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1075 S MAIN ST |
| Street Address 2 Of The Provider | STE 300 |
| City Of The Provider | MADISON |
| Zip Code Of The Provider | 306502074 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 27 |
| Number Of Services | 496 |
| Number Of Medicare Beneficiaries | 68 |
| Total Submitted Charge Amount | 38467 |
| Total Medicare Allowed Amount | 25774.29 |
| Total Medicare Payment Amount | 19965.73 |
| Total Medicare Standardized Payment Amount | 20636.04 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 76 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 1460 |
| Total Drug Medicare AllowedAmount | 147.69 |
| Total Drug Medicare PaymentAmount | 115.79 |
| Total Drug Medicare Standardized Payment Amount | 115.79 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 21 |
| Number Of Medical Services | 420 |
| Number Of Medicare Beneficiaries With Medical Services | 68 |
| Total Medical Submitted Charge Amount | 37007 |
| Total Medical Medicare Allowed Amount | 25626.6 |
| Total Medical Medicare Payment Amount | 19849.94 |
| Total Medical Medicare Standardized Payment Amount | 20520.25 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 11 |
| Number Of Beneficiaries Age 65 to 74 | 18 |
| Number Of Beneficiaries Age 75 to 84 | 23 |
| Number Of Beneficiaries Age Greater 84 | 16 |
| Number Of Female Beneficiaries | 38 |
| Number Of Male Beneficiaries | 30 |
| Number Of Non Hispanic White Beneficiaries | 52 |
| Number Of Black or African American Beneficiaries | |
| 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 | 41 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 27 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 32 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 44 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 41 |
| Percent Of With Diabetes | 53 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 68 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 2.0865 |