Alex Vrable, DO
General Practice · Youngstown, OHNPI 1710923040
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 99.8% of the total across 682 separate payments, which is the pattern of a clinician who attends manufacturer presentations rather than one with a consulting arrangement. It is spread thinly across 32 manufacturers, the largest accounting for just 14.3% — the pattern of someone who eats at a lot of different presentations. Reporting peaked in 2021 at $2,091 and has fallen 73.2% since, to $559 in 2025. Among general practice clinicians in OH with any reported payments, this total sits in the top 5% — high for the specialty, which is a reason to read the composition above rather than the number alone.
Across 682 payments — averaging $15.20 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Boehringer Ingelheim$1K
- AstraZeneca$1K
- AbbVie$926
- Johnson & Johnson$801
- Pfizer$771
- Merck$679
- plus $4K from 26 others
What the payments were for
- Food & beverage$10,346100%
- Education$220%
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 |
|---|---|---|
| Boehringer Ingelheim | 106 | $1,480 |
| AstraZeneca | 67 | $1,379 |
| AbbVie(2 entities) | 65 | $926 |
| Johnson & Johnson | 44 | $801 |
| Pfizer | 61 | $771 |
| Merck | 55 | $679 |
| Salix Pharmaceuticals, A Division Of Bausch Health US, LLC | 51 | $640 |
| Lilly USA, LLC | 25 | $470 |
| GSK | 32 | $468 |
| Takeda Pharmaceuticals U.S.A., Inc. | 26 | $379 |
| Novartis | 25 | $346 |
| Mylan Specialty L.p. | 19 | $298 |
| Novo Nordisk | 19 | $287 |
| Arbor Pharmaceuticals, Inc. | 16 | $247 |
| Abbott | 13 | $223 |
| E.r. Squibb & Sons, L.L.C. | 10 | $167 |
| Astellas Pharma US Inc | 7 | $112 |
| Amarin Pharma, Inc. | 7 | $95 |
| Exact Sciences | 4 | $94 |
| Esperion Therapeutics, Inc. | 5 | $80 |
| Biohaven Pharmaceuticals, Inc. | 4 | $63 |
| Hikma Pharmaceuticals USA | 3 | $55 |
| Sumitomo Pharma America, Inc. | 2 | $54 |
| Azurity Pharmaceuticals, Inc. | 3 | $48 |
| Amgen | 3 | $43 |
| Harmony Biosciences LLC | 2 | $35 |
| Supernus Pharmaceuticals, Inc. | 2 | $31 |
| Nevro Corp. | 2 | $29 |
| Teva Pharmaceuticals USA, Inc. | 1 | $21 |
| Axsome Therapeutics, Inc. | 1 | $18 |
| Lifescan, Inc. | 1 | $14 |
| Sebela Pharmaceuticals Inc. | 1 | $14 |
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.
- XARELTO$123
How this compares
$10,367 in reported general payments places this provider in the 95th percentile of 2,933 general practice providers in Ohio.
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 | 258 | $158,605 |
| JardianceEmpagliflozin | 145 | $137,618 |
| OzempicSemaglutide | 98 | $105,411 |
| Trelegy ElliptaFluticasone/Umeclidin/Vilanter | 74 | $49,157 |
| AptiomEslicarbazepine Acetate | 22 | $40,188 |
| JanuviaSitagliptin Phosphate | 50 | $36,338 |
| FarxigaDapagliflozin Propanediol | 23 | $28,743 |
| EntrestoSacubitril/Valsartan | 47 | $26,694 |
| Breztri AerosphereBudesonide/Glycopyr/Formoterol | 37 | $23,565 |
| RybelsusSemaglutide | 11 | $12,462 |
| GemtesaVibegron | 22 | $10,642 |
| BrilintaTicagrelor | 20 | $10,218 |
| TrintellixVortioxetine Hydrobromide | 14 | $8,906 |
| DuleraMometasone/Formoterol | 22 | $7,144 |
| Midodrine Hcl | 78 | $6,541 |
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 | $771 | $158,605258 claims |
| Boehringer IngelheimJardiance | $1,480 | $137,618145 claims |
| Novo NordiskOzempic, Rybelsus | $287 | $117,872109 claims |
| AstraZenecaFarxiga, Breztri Aerosphere, Brilinta | $1,379 | $62,52680 claims |
| GSKTrelegy Ellipta | $468 | $49,15774 claims |
| MerckJanuvia, Dulera, Janumet | $679 | $48,72184 claims |
| NovartisEntresto | $346 | $26,69447 claims |
| Sumitomo Pharma America, Inc.Gemtesa | $54 | $10,64222 claims |
| Takeda Pharmaceuticals U.S.A., Inc.Trintellix | $379 | $8,90614 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 95th percentile of 2,933 general practice providers in Ohio.
Other general practice in Youngstown
- Corey RaymondSalem$288K
- Heather PetroffBroadview Heights$170K
- Megan WeisenbergerCincinnati$81K
- Lundon AlbrechtMentor$77K
- Daniel WardColumbus$68K
- Ankur GuptaNorth Ridgeville$67K
- Jill BartonCanfield$48K
- Andrew SmithToledo$44K
- Steven LeungMayfield Hts$35K
- Maria van HuffelGahanna$30K
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.