Andrew Spangler, MD
Nephrology · Winston Salem, NCNPI 1578944013
Payments from drug & device makers
Across 476 payments — averaging $19.81 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- AstraZeneca$1K
- Amgen$1K
- Otsuka America Pharmaceutical, Inc.$680
- Travere Therapeutics, Inc.$610
- Vifor Pharma, Inc.$597
- Aurinia Pharma U.S., Inc.$545
- plus $4K from 28 others
What the payments were for
- Food & beverage$9,18897%
- Education$2393%
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 |
|---|---|---|
| AstraZeneca(2 entities) | 80 | $1,378 |
| Amgen(2 entities) | 49 | $1,124 |
| Otsuka America Pharmaceutical, Inc. | 33 | $680 |
| Travere Therapeutics, Inc. | 30 | $610 |
| Vifor Pharma, Inc. | 26 | $597 |
| Aurinia Pharma U.S., Inc. | 20 | $545 |
| Mallinckrodt Hospital Products Inc. | 27 | $542 |
| Bayer | 28 | $480 |
| ANI Pharmaceuticals, Inc. | 27 | $462 |
| Novartis | 24 | $381 |
| Boehringer Ingelheim | 21 | $373 |
| Novo Nordisk | 23 | $367 |
| Calliditas Therapeutics US Inc. | 6 | $236 |
| Akebia Therapeutics Inc | 13 | $225 |
| Takeda Pharmaceuticals U.S.A., Inc. | 6 | $146 |
| GSK | 9 | $145 |
| Bone Support Inc. | 1 | $144 |
| Fresenius USA Marketing, Inc. | 8 | $141 |
| OPKO Pharmaceuticals, LLC | 6 | $127 |
| Daiichi Sankyo Inc. | 5 | $120 |
| Shield Therapeutics Inc | 7 | $114 |
| Ardelyx, Inc. | 6 | $98 |
| Lilly USA, LLC | 5 | $82 |
| Apellis Pharmaceuticals, Inc. | 3 | $51 |
| Scpharmaceuticals Inc. | 2 | $41 |
| Cormedix Inc. | 2 | $41 |
| Argenx US, Inc. | 2 | $38 |
| Outset Medical Inc | 1 | $24 |
| Baxter Healthcare | 1 | $22 |
| Cycle Pharmaceuticals Inc | 1 | $20 |
| Kyowa Kirin, Inc. | 1 | $20 |
| Teleflex LLC | 1 | $19 |
| Genentech USA, Inc. | 1 | $18 |
| Bard Peripheral Vascular, Inc. | 1 | $16 |
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.
- CERAMENTBONE VOID FILLER$144
- TARPEYO$125
How this compares
$9,427 in reported general payments places this provider in the 75th percentile of 366 nephrology providers in North Carolina.
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 |
|---|---|---|
| FarxigaDapagliflozin Propanediol | 207 | $165,565 |
| JardianceEmpagliflozin | 113 | $109,942 |
| XphozahTenapanor Hcl | 12 | $40,312 |
| DapagliflozinDapagliflozin Propanediol | 21 | $10,726 |
| Sevelamer Carbonate | 22 | $3,572 |
| Potassium Citrate ErPotassium Citrate | 26 | $2,862 |
| Nifedipine ErNifedipine | 83 | $2,550 |
| Labetalol Hcl | 63 | $1,842 |
| Calcium Acetate | 16 | $1,828 |
| Calcitriol | 96 | $1,695 |
| Bumetanide | 56 | $1,537 |
| Losartan Potassium | 216 | $1,524 |
| Torsemide | 34 | $1,334 |
| Chlorthalidone | 75 | $1,288 |
| Cinacalcet Hcl | 16 | $1,179 |
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 |
|---|---|---|
| AstraZenecaFarxiga | $1,378 | $165,565207 claims |
| Boehringer IngelheimJardiance | $373 | $109,942113 claims |
| ANI Pharmaceuticals, Inc.Valsartan | $462 | $62014 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 75th percentile of 366 nephrology providers in North Carolina.
Other nephrology in Winston Salem
- Barry FreedmanWinston Salem$3.5M
- Michael RoccoWinston Salem$660K
- Nicholas McLeanWinston Salem$215K
- Scott SatkoWinston Salem$95K
- Anthony BleyerWinston Salem$71K
- Mariana MureaWinston Salem$36K
- Taewoo LeeWinston Salem$27K
- Daniel EdmonstonDurham$9.9M
- Gregory GreenwoodWinston-Salem$4.1M
- Manuel MonteroNew Bern$2.5M
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.