Alex Gifford, MD
Pulmonary Disease · Lebanon, NHNPI 1750397188
Payments from drug & device makers
What this record shows
This record is dominated by consulting fees: $6,400 of the $7,972 with a category attached, or 80.3%. Insmed, Inc. accounts for 97.8% of it on its own, with 4 other manufacturers making up the rest. Reporting peaked in 2019 at $7,796 and has fallen 99.8% since, to $15 in 2023.
Across 15 payments — averaging $531.48 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Insmed, Inc.$8K
- Mylan Specialty L.p.$119
- Boston Scientific$23
- Vertex$20
- AstraZeneca$15
Across 94 payments — averaging $5905.29 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.
- Vertex$323K
- Boehringer Ingelheim$108K
- AbbVie$77K
- Insmed, Inc.$43K
- Boehringer Ingelheim International GmbH$2K
- Boehringer Ingelheim Limited$1K
- plus $734 from 1 others
What the payments were for
- Consulting fees$6,40080%
- Travel & lodging$1,19215%
- Food & beverage$2804%
- Education$1001%
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 |
|---|---|---|
| Insmed, Inc. | 11 | $7,796 |
| Mylan Specialty L.p. | 1 | $119 |
| Boston Scientific | 1 | $23 |
| Vertex | 1 | $20 |
| AstraZeneca | 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.
- Arikayce$7,522
- TOBI Podhaler$119
How this compares
$7,972 in reported general payments places this provider in the 85th percentile of 78 pulmonary disease providers in New Hampshire.
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 |
|---|---|---|
| TrikaftaElexacaftor/Tezacaftor/Ivacaft | 152 | $4,047,115 |
| CreonLipase/Protease/Amylase | 37 | $266,617 |
| CaystonAztreonam Lysine | 18 | $219,909 |
| ZenpepLipase/Protease/Amylase | 28 | $168,748 |
| NucalaMepolizumab | 24 | $88,993 |
| Dupixent PenDupilumab | 11 | $40,999 |
| ColistimethateColistin (Colistimethate Na) | 20 | $14,541 |
| Breo ElliptaFluticasone/Vilanterol | 25 | $11,868 |
| Spiriva RespimatTiotropium Bromide | 14 | $10,024 |
| Breztri AerosphereBudesonide/Glycopyr/Formoterol | 11 | $9,448 |
| Advair HfaFluticasone Propion/Salmeterol | 26 | $8,737 |
| Stiolto RespimatTiotropium Br/Olodaterol Hcl | 15 | $7,156 |
| Fluticasone-SalmeterolFluticasone Propion/Salmeterol | 27 | $7,019 |
| MotegrityPrucalopride Succinate | 11 | $6,941 |
| Spiriva HandihalerTiotropium Bromide | 11 | $6,791 |
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 |
|---|---|---|
| VertexTrikafta | $20 | $4,047,115152 claims |
| AstraZenecaBreztri Aerosphere | $15 | $9,44811 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 85th percentile of 78 pulmonary disease providers in New Hampshire.
Other pulmonary disease in Lebanon
- Donald MahlerLebanon$411K
- Jeffrey StewartLebanon$30K
- Erik SwensonLebanon$29K
- Elliot BackerLebanon$24K
- H ParkerLebanon$13K
- Peter DelongLebanon$4K
- William WeissLebanon$1K
- John HoweLebanon$631
- John NuschkeLebanon$477
- James LeiterLebanon$77
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.