Astier Alem, MD
Nephrology · Kirkland, WANPI 1801849948
Payments from drug & device makers
What this record shows
This record is dominated by food and beverage: $848 of the $957 with a category attached, or 88.7%. 8 manufacturers reported payments, led by AstraZeneca at 42.5% of the total.
Across 30 payments — averaging $31.89 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- AstraZeneca$406
- Novartis$202
- Amgen$164
- GSK$101
- Travere Therapeutics, Inc.$31
- Ardelyx, Inc.$26
- plus $27 from 2 others
What the payments were for
- Food & beverage$84889%
- Education$10811%
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 | 8 | $406 |
| Novartis | 9 | $202 |
| Amgen(2 entities) | 7 | $164 |
| GSK | 1 | $101 |
| Travere Therapeutics, Inc. | 2 | $31 |
| Ardelyx, Inc. | 1 | $26 |
| Otsuka Pharmaceutical Development & Commercialization, Inc. | 1 | $15 |
| Vifor Pharma, Inc. | 1 | $12 |
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
$957 in reported general payments places this provider in the 75th percentile of 237 nephrology providers in Washington.
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 |
|---|---|---|
| XphozahTenapanor Hcl | 12 | $35,707 |
| Cinacalcet Hcl | 27 | $16,660 |
| Sevelamer Carbonate | 44 | $14,442 |
| LokelmaSodium Zirconium Cyclosilicate | 11 | $10,668 |
| Potassium Citrate ErPotassium Citrate | 21 | $3,162 |
| Calcium Acetate | 19 | $1,855 |
| Hydralazine Hcl | 112 | $1,848 |
| Losartan Potassium | 102 | $1,151 |
| Amlodipine Besylate | 163 | $1,149 |
| Calcitriol | 91 | $1,129 |
| Carvedilol | 105 | $1,065 |
| Verapamil ErVerapamil Hcl | 12 | $890 |
| Metoprolol Succinate | 62 | $827 |
| Allopurinol | 74 | $772 |
| Spironolactone | 40 | $670 |
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 |
|---|---|---|
| AstraZenecaLokelma | $406 | $10,66811 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 237 nephrology providers in Washington.
Other nephrology in Kirkland
- Kathrine TuttleSpokane$421K
- Osama AmroSeattle$395K
- Dmitri VasinBremerton$215K
- Ian de BoerSeattle$117K
- Nicolae LecaSeattle$101K
- Syeda AhmadSeattle$68K
- Charles MinnTacoma$67K
- Saw Hnin MuShoreline$25K
- Mahesh DangalVancouver$20K
- Stuart ShanklandSeattle$10K
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.