Alexandra Spirtos
Gynecologic Oncology · Las Vegas, NVNPI 1518354893
Payments from drug & device makers
What this record shows
This record is dominated by education: $6,075 of the $8,787 with a category attached, or 69.1%. Intuitive Surgical accounts for 68.3% of it on its own, with 21 other manufacturers making up the rest. Reporting peaked in 2024 at $6,861 and has fallen 89.0% since, to $753 in 2025.
Across 94 payments — averaging $93.48 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Intuitive Surgical$6K
- GSK$653
- Merck$487
- Genmab U.S., Inc.$371
- AstraZeneca$187
- AbbVie$184
- plus $905 from 16 others
What the payments were for
- Food & beverage$2,71231%
- Education$6,07569%
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 |
|---|---|---|
| Intuitive Surgical | 3 | $6,000 |
| GSK | 20 | $653 |
| Merck | 18 | $487 |
| Genmab U.S., Inc. | 13 | $371 |
| AstraZeneca | 8 | $187 |
| AbbVie | 6 | $184 |
| Biom'up France SAS | 1 | $158 |
| Seagen Inc. | 2 | $118 |
| Daiichi Sankyo Inc. | 5 | $109 |
| Genentech USA, Inc. | 1 | $102 |
| Eisai Inc. | 4 | $81 |
| Aadi Bioscience, Inc. | 1 | $58 |
| Tactile Systems Technology Inc | 2 | $57 |
| Caris MPI, Inc. | 2 | $54 |
| Tempus AI, Inc | 1 | $27 |
| Amneal Pharmaceuticals LLC | 1 | $26 |
| Solventum Corporation | 1 | $26 |
| Coloplast | 1 | $26 |
| Olympus America Inc. | 1 | $18 |
| BD | 1 | $15 |
| Koya Medical, Inc. | 1 | $15 |
| Conmed Corporation | 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.
- DAVINCI XI$6,000
- ZEJULA$236
- HemoBlast Bellows$158
- JEMPERLI$121
- KEYTRUDA$114
- TIVDAK$105
- Avastin$102
How this compares
Too few gynecologic oncology providers in Nevadato place this figure against a meaningful peer group, so we don't.
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 |
|---|---|---|
| Megestrol Acetate | 14 | $1,494 |
| Dexamethasone | 26 | $459 |
| Ondansetron Hcl | 23 | $263 |
| Olanzapine | 14 | $141 |
| Oxycodone Hcl | 27 | $108 |
| Metoclopramide Hcl | 27 | $93 |
| Gabapentin | 12 | $54 |
| Hydrocodone-AcetaminophenHydrocodone/Acetaminophen | 13 | $41 |
Paid to pharmacies, not to this prescriber.
Other gynecologic oncology in Las Vegas
- Lynn KowalskiLas Vegas$15K
- Natalie GouldLas Vegas$3K
- Nicola SpirtosLas Vegas$2K
- Robert FutoranLas Vegas$1K
- Cheryl BrewerLas Vegas$1K
- Aimee FleuryLas Vegas$1K
- Raymond TurnerLas Vegas$285
- Mary EngelhardtHenderson$2K
- Lauren MontemoranoReno$1K
- Camille FalknerHenderson$71
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.