Alexander Gamble, DO
Neurological Surgery · Bedford, NHNPI 1518266410
Payments from drug & device makers
What this record shows
The money is spread across several categories — food and beverage (50.1%), travel and lodging and consulting fees — rather than concentrated in one kind of arrangement. 25 manufacturers reported payments, led by Stryker at 35.3% of the total. Reporting peaked in 2024 at $9,708 and has fallen 70.1% since, to $2,903 in 2025.
Across 291 payments — averaging $79.57 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Stryker$8K
- Alphatec Spine, Inc$7K
- Depuy Synthes Products, Inc.$3K
- Medtronic$1K
- Johnson & Johnson$1K
- VB Spine LLC$488
- plus $2K from 19 others
What the payments were for
- Consulting fees$2,32410%
- Travel & lodging$9,20440%
- Food & beverage$11,60850%
- Education$200%
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 |
|---|---|---|
| Stryker | 138 | $8,168 |
| Alphatec Spine, Inc | 49 | $7,481 |
| Depuy Synthes Products, Inc. | 3 | $2,580 |
| Medtronic | 22 | $1,191 |
| Johnson & Johnson | 26 | $1,011 |
| VB Spine LLC | 10 | $488 |
| Spine Wave, Inc. | 11 | $372 |
| Lifenet Health | 3 | $256 |
| Abbott | 4 | $247 |
| AbbVie | 9 | $243 |
| Orthofix Medical, Inc. | 2 | $191 |
| Kuros Biosciences USA, Inc | 1 | $142 |
| Precision Spine, Inc. | 1 | $124 |
| Medexus Pharma, Inc. | 1 | $118 |
| Ossdsign USA Incorporated | 1 | $117 |
| Biocomposites Inc | 1 | $112 |
| Choice Spine, LLC | 1 | $83 |
| Neo Spine USA, Inc. | 1 | $61 |
| Globus Medical | 1 | $47 |
| Cerapedics Inc. | 1 | $33 |
| Si-bone, Inc. | 1 | $22 |
| Radius Health, Inc. | 1 | $22 |
| CSL Behring | 1 | $20 |
| Smith+Nephew | 1 | $16 |
| Shionogi 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.
- Other - Miscellaneous$4,428
- GENERAL K2M PRODUCT DISCUSSION$402
- XIA$375
- O-ARM$284
- INVICTUS OPEN$211
- STEALTHSTATION S8 PLATFORM$174
- SPINEMASK$172
- EVEREST XT$155
- MAZOR X SYSTEM$150
- STRATA$149
- ETERNA$144
- CASCADIA$142
- MagnetOs$142
- LATERAL ACCESS SPINAL SYSTEM$134
- REFORM POCT SYSTEM$124
- M6-C$123
- EVEREST MI$122
- Allograft VMIS Delivery System$122
- NAPA ACCESS SYSTEM$122
- CASCADIA INTERBODY SYSTEM$120
How this compares
$23,156 in reported general payments places this provider in the 85th percentile of 32 neurological surgery 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 |
|---|---|---|
| Pregabalin | 49 | $1,440 |
| Oxycodone Hcl | 62 | $854 |
| Celecoxib | 23 | $644 |
| Levetiracetam | 23 | $459 |
| Hydrocodone-AcetaminophenHydrocodone/Acetaminophen | 19 | $258 |
| Diclofenac Sodium | 27 | $246 |
| Baclofen | 13 | $241 |
| Gabapentin | 12 | $164 |
| Diazepam | 34 | $107 |
| Tizanidine Hcl | 27 | $106 |
| Methylprednisolone | 12 | $74 |
| Tramadol Hcl | 15 | $63 |
| Cyclobenzaprine Hcl | 11 | $59 |
| Oxycodone-AcetaminophenOxycodone Hcl/Acetaminophen | 14 | $29 |
Paid to pharmacies, not to this prescriber.
Other neurological surgery in Bedford
- Kota KaranthBedford$4K
- Neal LutherBedford$2K
- Paul WangBedford$1K
- Nigel JenkinsBedford$121
- Nevan BaldwinLebanon$214K
- Joshua AronsonLebanon$78K
- Anthony SalerniGilford$64K
- Tung NguyenNashua$52K
- Xiaonan SunLebanon$21K
- David KungLebanon$12K
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.