Douglas Kosmicki, MD
Interventional Cardiology · Grand Island, NENPI 1295840130
Payments from drug & device makers
What this record shows
This record is dominated by food and beverage: $1,805 of the $2,740 with a category attached, or 65.9%. 23 manufacturers reported payments, led by Edwards Lifesciences at 51.8% of the total. Reporting peaked in 2019 at $1,564 and has fallen 85.1% since, to $234 in 2025. That places this record below the midpoint for interventional cardiology clinicians in NE, where the typical reported total is $6,648.
Across 91 payments — averaging $30.11 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Edwards Lifesciences$1K
- Medtronic$243
- United Therapeutics Corporation$146
- AstraZeneca$140
- Novartis$138
- Pfizer$81
- plus $572 from 17 others
Across 75 payments — averaging $3324.91 each. Payments tied to a research study. These frequently flow through the physician to a hospital or research institution rather than to the physician personally.
- Novartis$168K
- Bayer$36K
- AstraZeneca$20K
- ZOLL Services LLC (a/k/a ZOLL Lifecor Corp)$17K
- Boehringer Ingelheim International GmbH$9K
What the payments were for
- Travel & lodging$92434%
- Food & beverage$1,80566%
- Education$120%
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 |
|---|---|---|
| Edwards Lifesciences | 26 | $1,419 |
| Medtronic(2 entities) | 9 | $243 |
| United Therapeutics Corporation | 4 | $146 |
| AstraZeneca | 11 | $140 |
| Novartis | 9 | $138 |
| Pfizer | 5 | $81 |
| Boston Scientific | 4 | $76 |
| Johnson & Johnson | 4 | $73 |
| Abbott | 1 | $64 |
| Itamar Medical Inc | 1 | $44 |
| Gilead | 2 | $37 |
| Bridgebio Pharma, Inc. | 1 | $36 |
| Chiesi USA, Inc. | 2 | $33 |
| Sanofi-aventis U.S. LLC | 2 | $31 |
| Merck | 2 | $30 |
| Lexicon Pharmaceuticals, Inc. | 1 | $25 |
| AbbVie | 1 | $22 |
| Actelion Pharmaceuticals US, Inc. | 1 | $21 |
| ZOLL Services LLC (a/k/a ZOLL Lifecor Corp) | 1 | $20 |
| Alnylam Pharmaceuticals Inc. | 1 | $19 |
| Abiomed | 1 | $15 |
| Terumo Medical Corporation | 1 | $14 |
| Kowa Pharmaceuticals America, Inc. | 1 | $12 |
What the payments were tied to
Products named in the reported payments. Only payments of $100 or more are attributed here — the typical reported payment nationally is a meal worth about $16, and listing those product-by-product would be noise.
How this compares
$2,740 in reported general payments places this provider in the 25th percentile of 50 interventional cardiology providers in Nebraska.
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 |
|---|---|---|
| EliquisApixaban | 334 | $252,704 |
| XareltoRivaroxaban | 154 | $137,765 |
| Repatha SureclickEvolocumab | 62 | $51,157 |
| EntrestoSacubitril/Valsartan | 30 | $19,654 |
| BrilintaTicagrelor | 26 | $14,751 |
| Praluent PenAlirocumab | 23 | $11,757 |
| Flecainide Acetate | 180 | $7,629 |
| Metoprolol Succinate | 561 | $6,102 |
| FarxigaDapagliflozin Propanediol | 11 | $6,078 |
| Ranolazine ErRanolazine | 70 | $2,892 |
| Atorvastatin Calcium | 399 | $2,867 |
| Potassium Chloride | 203 | $2,414 |
| SotalolSotalol Hcl | 147 | $1,867 |
| Carvedilol | 201 | $1,670 |
| Nebivolol Hcl | 47 | $1,625 |
Paid to pharmacies, not to this prescriber.
Companies that both paid and supply prescribed drugs
These companies both reported payments to this provider and make drugs the provider prescribed under Medicare Part D in 2024. For most specialties this overlap is expected — a cardiologist who is paid by a cardiology drugmaker also treats heart disease. It is shown so the reader can see it, not because it implies anything on its own.
| Company | Paid to this provider | Part D cost of their drugs |
|---|---|---|
| PfizerEliquis | $81 | $252,704334 claims |
| Johnson & JohnsonXarelto | $73 | $137,765154 claims |
| AstraZenecaBrilinta, Farxiga | $140 | $20,82937 claims |
| NovartisEntresto | $138 | $19,65430 claims |
Reading this fairly. The Part D column is what drug plans and patients paid pharmacies — this provider received none of it, and it reflects how many patients they treat and what those drugs cost. Against peers, this provider's reported payments sit in the 25th percentile of 50 interventional cardiology providers in Nebraska.
Other interventional cardiology in Grand Island
- Zachary OmanGrand Island$17K
- Erich FruehlingGrand Island$3K
- Brock CookmanLincoln$782K
- Himanshu AgarwalOmaha$541K
- Matthew JohnsonLincoln$162K
- Poonam VelagapudiOmaha$142K
- Steven MartinLincoln$55K
- Andrew GoldsweigOmaha$49K
- Jai ParekhOmaha$44K
- James HallKearney$36K
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.