Alvaro Changco
Family Medicine · Cokeburg, PANPI 1922009240
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 100.0% of the total across 199 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 25 manufacturers, the largest accounting for just 20.2% — the pattern of someone who eats at a lot of different presentations. 2025 is the largest year on record at $689, more than ten times the $15 reported in 2019.
Across 199 payments — averaging $16.34 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Pfizer$656
- Lilly USA, LLC$575
- Novo Nordisk$449
- Bayer$348
- Exact Sciences$195
- GSK$149
- plus $879 from 19 others
What the payments were for
- Food & beverage$3,251100%
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 |
|---|---|---|
| Pfizer | 41 | $656 |
| Lilly USA, LLC | 37 | $575 |
| Novo Nordisk | 25 | $449 |
| Bayer | 22 | $348 |
| Exact Sciences | 10 | $195 |
| GSK | 9 | $149 |
| Abbott | 8 | $123 |
| AbbVie | 5 | $92 |
| Amgen | 6 | $89 |
| Boehringer Ingelheim | 5 | $83 |
| Merck | 4 | $72 |
| Esperion Therapeutics, Inc. | 4 | $67 |
| Shield Therapeutics Inc | 4 | $65 |
| AstraZeneca | 4 | $52 |
| Astellas Pharma US Inc | 2 | $35 |
| Johnson & Johnson | 2 | $27 |
| Dexcom, Inc. | 2 | $27 |
| Sanofi Pasteur Inc. | 1 | $23 |
| Sanofi-aventis U.S. LLC | 2 | $23 |
| Insulet Corporation | 1 | $21 |
| Edwards Lifesciences | 1 | $20 |
| Phadia US Inc. | 1 | $17 |
| Phathom Pharmaceuticals, Inc. | 1 | $15 |
| Salix Pharmaceuticals, A Division Of Bausch Health US, LLC | 1 | $14 |
| Biohaven Pharmaceutical Holding Company Ltd. | 1 | $13 |
How this compares
$3,251 in reported general payments places this provider in the 80th percentile of 4,967 family medicine providers in Pennsylvania.
Most prescribed under Part D
| Drug | Claims | Cost to plans & patients |
|---|---|---|
| EliquisApixaban | 158 | $119,726 |
| JardianceEmpagliflozin | 101 | $82,521 |
| Trelegy ElliptaFluticasone/Umeclidin/Vilanter | 78 | $54,811 |
| OzempicSemaglutide | 45 | $46,469 |
| XareltoRivaroxaban | 45 | $36,183 |
| TrulicityDulaglutide | 20 | $22,389 |
| FarxigaDapagliflozin Propanediol | 16 | $19,844 |
| LinzessLinaclotide | 31 | $19,435 |
| MounjaroTirzepatide | 16 | $16,367 |
| MyrbetriqMirabegron | 30 | $15,086 |
| JanuviaSitagliptin Phosphate | 17 | $14,518 |
| Anoro ElliptaUmeclidinium Brm/Vilanterol Tr | 22 | $14,012 |
| EntrestoSacubitril/Valsartan | 16 | $11,786 |
| Breztri AerosphereBudesonide/Glycopyr/Formoterol | 15 | $9,469 |
| Spiriva RespimatTiotropium Bromide | 14 | $7,991 |
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 | $656 | $119,726158 claims |
| Boehringer IngelheimJardiance, Spiriva Respimat, Tradjenta | $83 | $95,849126 claims |
| GSKTrelegy Ellipta, Anoro Ellipta, Incruse Ellipta, Breo Ellipta | $149 | $79,377124 claims |
| Novo NordiskOzempic | $449 | $46,46945 claims |
| Lilly USA, LLCTrulicity, Mounjaro | $575 | $38,75636 claims |
| Johnson & JohnsonXarelto | $27 | $36,18345 claims |
| AstraZenecaFarxiga, Breztri Aerosphere, Symbicort | $52 | $34,50743 claims |
| AbbVieLinzess, Synthroid | $92 | $24,558101 claims |
| Astellas Pharma US IncMyrbetriq | $35 | $15,08630 claims |
| MerckJanuvia | $72 | $14,51817 claims |
| Sanofi-aventis U.S. LLCLantus | $23 | $1,73814 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 80th percentile of 4,967 family medicine providers in Pennsylvania.
Other family medicine in Cokeburg
- Neil SkolnikJenkintown$904K
- Lisa EspinozaNew Hope$722K
- Christopher Varacallodu Bois$627K
- Paul DoghramjiCollegeville$617K
- Brian DeyarminBethel Park$491K
- Nathan BennettPittsburgh$465K
- Gary OwensGlen Mills$404K
- Mary ZakutneyIrwin$393K
- H WilkinsSellersville$380K
- Deborah WittPhiladelphia$226K
Where these figures come from
- Payments: CMS Open Payments, program years 2019–2025 (publication P06302026_06032026).
- Identity: NPPES NPI Registry, July 2026.