April Mieswinkel
Family · Orlando, FLNPI 1336334234
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 96.8% of the total across 298 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 48 manufacturers, the largest accounting for just 11.2% — the pattern of someone who eats at a lot of different presentations. Reporting peaked in 2021 at $1,936 and has fallen 96.9% since, to $61 in 2025. Among family clinicians in FL with any reported payments, this total sits in the top 10% — high for the specialty, which is a reason to read the composition above rather than the number alone.
Across 298 payments — averaging $15.47 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- AstraZeneca$518
- Pfizer$484
- AbbVie$322
- Lilly USA, LLC$277
- Abbott$251
- Neurocrine Biosciences, Inc.$231
- plus $3K from 42 others
What the payments were for
- Speaking & faculty fees$271%
- Food & beverage$4,46297%
- Education$1203%
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.
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.
- BREZTRI$112
How this compares
$4,610 in reported general payments places this provider in the 90th percentile of 14,618 family providers in Florida.
Most prescribed under Part D
| Drug | Claims | Cost to plans & patients |
|---|---|---|
| VascepaIcosapent Ethyl | 15 | $6,196 |
| Divalproex Sodium ErDivalproex Sodium | 13 | $1,365 |
| Metformin Hcl | 16 | $334 |
Paid to pharmacies, not to this prescriber.
Other family in Orlando
- Donna OrtizOrlando$417K
- Lindsey McCabeOrlando$37K
- Lewis HarringtonTampa$954K
- Danielle PharesFt Lauderdale$713K
- Patrick SzarazMiami$327K
- Deena RodneyMaitland$323K
- Yamila MelendezMiami$212K
- Holly BoydLand O Lakes$200K
- Rachael BuschLoxahatchee$189K
- Victor Tatis de la NuezMiramar$161K
Where these figures come from
- Payments: CMS Open Payments, program years 2019–2025 (publication P06302026_06032026).
- Identity: NPPES NPI Registry, July 2026.