Alfreda Shields
Nurse Practitioner · Saint Louis, MONPI 1497021810
Payments from drug & device makers
Across 126 payments — averaging $47.43 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Teva Pharmaceuticals USA, Inc.$1K
- Johnson & Johnson$1K
- E.r. Squibb & Sons, L.L.C.$850
- Otsuka America Pharmaceutical, Inc.$837
- Alkermes, Inc.$568
- Neurocrine Biosciences, Inc.$559
- plus $885 from 7 others
What the payments were for
- Food & beverage$5,82798%
- Education$1482%
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 |
|---|---|---|
| Teva Pharmaceuticals USA, Inc. | 19 | $1,178 |
| Johnson & Johnson | 27 | $1,099 |
| E.r. Squibb & Sons, L.L.C. | 8 | $850 |
| Otsuka America Pharmaceutical, Inc. | 23 | $837 |
| Alkermes, Inc. | 14 | $568 |
| Neurocrine Biosciences, Inc. | 9 | $559 |
| ITI, Inc. (d/b/a Intra-cellular Therapies, Inc.) | 11 | $398 |
| AbbVie | 7 | $241 |
| Otsuka Pharmaceutical Development & Commercialization, Inc. | 2 | $129 |
| Indivior Inc. | 3 | $51 |
| Takeda Pharmaceuticals U.S.A., Inc. | 1 | $25 |
| Lundbeck LLC | 1 | $24 |
| Vanda Pharmaceuticals Inc. | 1 | $17 |
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.
- LYBALVI$865
- COBENFY$632
- Austedo XR$598
- INVEGA SUSTENNA$440
- ARISTADA$424
- REXULTI$245
- CAPLYTA$235
- UZEDY$232
- SPRAVATO$151
- ABILIFY MAINTENA$125
- ABILIFY ASIMTUFII$125
- VRAYLAR$125
- INGREZZA$119
- ARISTADA INITIO$106
How this compares
$5,976 in reported general payments places this provider in the 95th percentile of 1,898 nurse practitioner providers in Missouri.
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 |
|---|---|---|
| Invega SustennaPaliperidone Palmitate | 54 | $161,900 |
| AristadaAripiprazole Lauroxil | 30 | $91,845 |
| VivitrolNaltrexone Microspheres | 42 | $68,342 |
| Abilify MaintenaAripiprazole | 17 | $48,268 |
| LybalviOlanzapine/Samidorphan Malate | 13 | $20,584 |
| Buprenorphine-NaloxoneBuprenorphine Hcl/Naloxone Hcl | 12 | $9,617 |
| Olanzapine OdtOlanzapine | 61 | $6,599 |
| Clozapine | 13 | $4,341 |
| Divalproex Sodium ErDivalproex Sodium | 41 | $2,986 |
| Haloperidol Decanoate | 45 | $2,488 |
| Naltrexone Hcl | 31 | $1,518 |
| Olanzapine | 77 | $1,251 |
| Fluphenazine Decanoate | 30 | $1,205 |
| LoxapineLoxapine Succinate | 33 | $1,165 |
| Quetiapine Fumarate | 63 | $1,028 |
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 |
|---|---|---|
| Alkermes, Inc.Aristada, Vivitrol, Lybalvi | $568 | $180,77185 claims |
| Johnson & JohnsonInvega Sustenna | $1,099 | $161,90054 claims |
| Otsuka America Pharmaceutical, Inc.Abilify Maintena | $837 | $48,26817 claims |
| Teva Pharmaceuticals USA, Inc.Loxapine | $1,178 | $1,16533 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 1,898 nurse practitioner providers in Missouri.
Other nurse practitioner in Saint Louis
- Carrie Roth BettlachSaint Louis$21K
- Lisa CampbellSaint Louis$16K
- Angela VickroySaint Louis$15K
- Isabel HartigSaint Louis$13K
- Kathryn LindsaySaint Louis$13K
- Leanna ScheidemantelSaint Louis$12K
- Samra FajicSaint Louis$12K
- Debra GaseSaint Louis$11K
- Kristin DalySaint Louis$11K
- Kimbra CardwellSaint Louis$11K
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.