Ann Narmi, MD
Interventional Cardiology · Council Bluffs, IANPI 1134348071
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 99.5% of the total across 82 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 18 manufacturers, the largest accounting for just 22.8% — the pattern of someone who eats at a lot of different presentations. 2025 is the largest year on record at $766, 2.1 times the $371 reported in 2019. That places this record below the midpoint for interventional cardiology clinicians in IA, where the typical reported total is $3,872.
Across 82 payments — averaging $32.26 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Medtronic$604
- Boston Scientific$453
- Shockwave Medical, Inc$449
- Abiomed$353
- Chiesi USA, Inc.$186
- Novartis$184
- plus $416 from 12 others
What the payments were for
- Food & beverage$2,633100%
- Education$120%
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 |
|---|---|---|
| Medtronic(2 entities) | 10 | $604 |
| Boston Scientific | 8 | $453 |
| Shockwave Medical, Inc | 12 | $449 |
| Abiomed | 5 | $353 |
| Chiesi USA, Inc. | 10 | $186 |
| Novartis | 9 | $184 |
| Pfizer | 5 | $69 |
| Johnson & Johnson | 4 | $61 |
| Abbott | 2 | $48 |
| Amgen | 3 | $44 |
| Regeneron Healthcare Solutions, Inc. | 2 | $36 |
| E.r. Squibb & Sons, L.L.C. | 2 | $34 |
| Sanofi-aventis U.S. LLC | 2 | $33 |
| ZOLL Services LLC (a/k/a ZOLL Lifecor Corp) | 4 | $30 |
| Edwards Lifesciences | 1 | $21 |
| Lundbeck LLC | 1 | $16 |
| Scpharmaceuticals Inc. | 1 | $14 |
| Boehringer Ingelheim | 1 | $11 |
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.
How this compares
$2,645 in reported general payments places this provider in the 35th percentile of 64 interventional cardiology providers in Iowa.
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 |
|---|---|---|
| EliquisApixaban | 264 | $249,692 |
| XareltoRivaroxaban | 75 | $74,437 |
| EntrestoSacubitril/Valsartan | 37 | $64,316 |
| MounjaroTirzepatide | 46 | $51,659 |
| BrilintaTicagrelor | 12 | $8,813 |
| Repatha SureclickEvolocumab | 12 | $7,881 |
| Metoprolol Succinate | 513 | $5,332 |
| Flecainide Acetate | 44 | $3,796 |
| Amiodarone Hcl | 135 | $2,992 |
| Atorvastatin Calcium | 311 | $2,892 |
| Potassium Chloride | 165 | $2,188 |
| Diltiazem 24hr Er (Cd)Diltiazem Hcl | 72 | $1,642 |
| ClopidogrelClopidogrel Bisulfate | 136 | $1,543 |
| Amlodipine Besylate | 237 | $1,352 |
| Bumetanide | 52 | $1,061 |
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 | $69 | $249,692264 claims |
| Johnson & JohnsonXarelto | $61 | $74,43775 claims |
| NovartisEntresto | $184 | $64,31637 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 35th percentile of 64 interventional cardiology providers in Iowa.
Other interventional cardiology in Council Bluffs
- Robert ArmbrusterCouncil Bluffs$7K
- Anthony DeciccoCouncil Bluffs$3K
- Nicolas ShammasDavenport$808K
- Eric DippelDavenport$100K
- Atul ChawlaDes Moines$78K
- Magdi GhaliWest Des Moines$64K
- David McAllisterDes Moines$55K
- Daniel ShivapourDes Moines$54K
- Srikanth KasulaDavenport$43K
- Abdulrahman AbdulbakiDes Moines$43K
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.