| National Provider Identifier [NPI]: | 1265405260 |
| Last Name Of The Provider | COSSIO |
| First Name Of The Provider | MOISES |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2001 CRYSTAL SPRING AVE SW |
| Street Address 2 Of The Provider | SUITE 205 |
| City Of The Provider | ROANOKE |
| Zip Code Of The Provider | 240142462 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 46 |
| Number Of Services | 1293 |
| Number Of Medicare Beneficiaries | 476 |
| Total Submitted Charge Amount | 239531 |
| Total Medicare Allowed Amount | 153819.13 |
| Total Medicare Payment Amount | 118226.69 |
| Total Medicare Standardized Payment Amount | 121019.2 |
| 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 | 46 |
| Number Of Medical Services | 1293 |
| Number Of Medicare Beneficiaries With Medical Services | 476 |
| Total Medical Submitted Charge Amount | 239531 |
| Total Medical Medicare Allowed Amount | 153819.13 |
| Total Medical Medicare Payment Amount | 118226.69 |
| Total Medical Medicare Standardized Payment Amount | 121019.2 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 140 |
| Number Of Beneficiaries Age 65 to 74 | 168 |
| Number Of Beneficiaries Age 75 to 84 | 123 |
| Number Of Beneficiaries Age Greater 84 | 45 |
| Number Of Female Beneficiaries | 274 |
| Number Of Male Beneficiaries | 202 |
| Number Of Non Hispanic White Beneficiaries | 422 |
| 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 | 321 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 155 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 21 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 53 |
| Percent Of With Chronic Kidney Disease | 48 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 62 |
| Percent Of With Depression | 41 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 57 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 2.3077 |