Alexander Spira, MD
Medical Oncology · Fairfax, VANPI 1902874514
Payments from drug & device makers
What this record shows
This record is dominated by consulting fees: $483,865 of the $532,548 with a category attached, or 90.9%. It is spread thinly across 60 manufacturers, the largest accounting for just 13.0%. 2025 is the largest year on record at $106,744, 2.0 times the $52,629 reported in 2019. Among medical oncology clinicians in VA 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 472 payments — averaging $1128.28 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- AstraZeneca$69K
- Johnson & Johnson$60K
- Foundation Medicine, Inc.$45K
- Takeda Pharmaceuticals U.S.A., Inc.$37K
- Janssen Global Services, LLC$27K
- Daiichi Sankyo Inc.$26K
- plus $268K from 54 others
Across 7,710 payments — averaging $8963.80 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$10M
- Daiichi Sankyo Inc.$7.3M
- AstraZeneca$7.3M
- Mirati Therapeutics, Inc.$6.8M
- AbbVie$3.2M
- Novartis$2.6M
- plus $31.7M from 54 others
What the payments were for
- Consulting fees$483,86591%
- Speaking & faculty fees$18,9434%
- Travel & lodging$21,7054%
- Food & beverage$7,9912%
- Education$440%
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.
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.
- RYBREVANT$71,937
- FOUNDATIONONE CDX$44,775
- FOUNDATIONONE LIQUID$39,025
- FOUNDATIONFOCUS$39,025
- FOUNDATIONONE HEME$39,025
- FOUNDATIONONE$39,025
- TAGRISSO$27,047
- IMFINZI$20,978
- EXKIVITY$18,878
- LIBTAYO$17,272
- ALUNBRIG$5,400
- Enhertu$4,995
- Tepmetko$4,830
- LUMAKRAS$4,543
- RETEVMO$4,500
- ZEPZELCA$4,125
- ILARIS$2,820
- FYARRO$2,730
- Vitrakvi$2,100
- Tepotinib$2,070
How this compares
$532,548 in reported general payments places this provider in the 95th percentile of 95 medical oncology providers in Virginia.
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 |
|---|---|---|
| LorbrenaLorlatinib | 58 | $1,158,457 |
| TagrissoOsimertinib Mesylate | 57 | $955,855 |
| AlecensaAlectinib Hcl | 39 | $737,907 |
| AlunbrigBrigatinib | 12 | $232,438 |
| EliquisApixaban | 30 | $19,641 |
| Dexamethasone | 14 | $316 |
| Prochlorperazine Maleate | 16 | $213 |
| Levothyroxine Sodium | 12 | $151 |
| Prednisone | 23 | $97 |
| Spironolactone | 16 | $80 |
| Furosemide | 11 | $43 |
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 |
|---|---|---|
| PfizerLorbrena, Eliquis | $2,040 | $1,178,09888 claims |
| AstraZenecaTagrisso | $69,318 | $955,85557 claims |
| Genentech USA, Inc.Alecensa | $13,300 | $737,90739 claims |
| Takeda Pharmaceuticals U.S.A., Inc.Alunbrig | $36,989 | $232,43812 claims |
| Amneal Pharmaceuticals LLCLevothyroxine Sodium | $19 | $15112 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 95 medical oncology providers in Virginia.
Other medical oncology in Fairfax
- Janakiraman SubramanianFairfax$562K
- Roy BeveridgeFairfax$216K
- Kathleen HarndenFairfax$195K
- Nagla Abdel KarimFairfax$131K
- Lauren MauroFairfax$53K
- Donald TrumpFairfax$20K
- Timothy CannonFairfax$11K
- Arthur WinerFairfax$10K
- Danijela JelovacFairfax$7K
- Eun-Mi YuFairfax$7K
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.