Maxwell Cosmic, MD
Pulmonary Disease · Des Moines, IANPI 1164408548
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 99.0% of the total across 43 separate payments, which is the pattern of a clinician who attends manufacturer presentations rather than one with a consulting arrangement. 16 manufacturers reported payments, led by United Therapeutics Corporation at 35.8% of the total.
Across 43 payments — averaging $78.31 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- United Therapeutics Corporation$1K
- Actelion Pharmaceuticals US, Inc.$1K
- Sanofi$179
- La Jolla Pharmaceutical Company$159
- Boehringer Ingelheim$150
- Merck$126
- plus $418 from 10 others
Across 7 payments — averaging $2278.57 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.
- Janssen Research & Development, LLC$8K
- Actelion Pharmaceuticals, Ltd$8K
What the payments were for
- Food & beverage$3,33499%
- Education$331%
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 |
|---|---|---|
| United Therapeutics Corporation | 11 | $1,205 |
| Actelion Pharmaceuticals US, Inc. | 9 | $1,131 |
| Sanofi | 3 | $179 |
| La Jolla Pharmaceutical Company | 2 | $159 |
| Boehringer Ingelheim | 3 | $150 |
| Merck | 2 | $126 |
| Verona Pharma, Inc. | 1 | $121 |
| Grifols USA, LLC | 2 | $95 |
| Amgen | 2 | $48 |
| Insmed, Inc. | 2 | $30 |
| Regeneron Healthcare Solutions, Inc. | 1 | $25 |
| Baxter Healthcare | 1 | $24 |
| GSK | 1 | $23 |
| Abiomed | 1 | $21 |
| CSL Behring | 1 | $17 |
| Electromed, Inc. | 1 | $15 |
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
$3,367 in reported general payments places this provider in the 60th percentile of 110 pulmonary disease 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 |
|---|---|---|
| Trelegy ElliptaFluticasone/Umeclidin/Vilanter | 294 | $236,588 |
| AdempasRiociguat | 17 | $232,351 |
| Breo ElliptaFluticasone/Vilanterol | 84 | $51,234 |
| Anoro ElliptaUmeclidinium Brm/Vilanterol Tr | 87 | $43,454 |
| Arnuity ElliptaFluticasone Furoate | 79 | $24,435 |
| Spiriva RespimatTiotropium Bromide | 29 | $16,487 |
| Spiriva HandihalerTiotropium Bromide | 21 | $15,393 |
| DuleraMometasone/Formoterol | 29 | $13,885 |
| Incruse ElliptaUmeclidinium Bromide | 27 | $10,296 |
| Fluticasone-SalmeterolFluticasone Propion/Salmeterol | 43 | $9,199 |
| EliquisApixaban | 15 | $8,219 |
| Albuterol Sulfate HfaAlbuterol Sulfate | 249 | $8,034 |
| SymbicortBudesonide/Formoterol Fumarate | 22 | $6,023 |
| Bevespi AerosphereGlycopyrrolate/Formoterol Fum | 14 | $5,999 |
| Ventolin HfaAlbuterol Sulfate | 48 | $2,713 |
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 |
|---|---|---|
| GSKTrelegy Ellipta, Breo Ellipta, Anoro Ellipta, Arnuity Ellipta, Incruse Ellipta | $23 | $366,006571 claims |
| Boehringer IngelheimSpiriva Respimat | $150 | $16,48729 claims |
| MerckDulera | $126 | $13,88529 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 60th percentile of 110 pulmonary disease providers in Iowa.
Other pulmonary disease in Des Moines
- Shrey VelaniDes Moines$18K
- Neil HorningDes Moines$15K
- Jason WittmerDes Moines$10K
- Bradley WilcoxDes Moines$7K
- Blair WesterlyDes Moines$7K
- Eric AsbeDes Moines$4K
- Anthony GrecoDes Moines$3K
- Lucas Silqueira Hickson CruzDes Moines$2K
- Maksym PuliaievDes Moines$2K
- Bryon JohnsonDes Moines$1K
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.