Avie Grunspan, MD
Sleep Medicine · San Antonio, TXNPI 1881695542
Payments from drug & device makers
What this record shows
This record is dominated by food and beverage: $2,704 of the $3,142 with a category attached, or 86.1%. 22 manufacturers reported payments, led by Harmony Biosciences LLC at 39.3% of the total. Reporting peaked in 2023 at $829 and has fallen 72.9% since, to $225 in 2025.
Across 131 payments — averaging $23.98 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Harmony Biosciences LLC$1K
- Jazz Pharmaceuticals Inc.$494
- Avadel CNS Pharmaceuticals, LLC$319
- Regeneron Healthcare Solutions, Inc.$163
- Fisher & Paykel Healthcare Inc$161
- Axsome Therapeutics, Inc.$122
- plus $648 from 16 others
What the payments were for
- Consulting fees$2006%
- Food & beverage$2,70486%
- Education$2388%
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 |
|---|---|---|
| Harmony Biosciences LLC | 55 | $1,235 |
| Jazz Pharmaceuticals Inc. | 21 | $494 |
| Avadel CNS Pharmaceuticals, LLC | 7 | $319 |
| Regeneron Healthcare Solutions, Inc. | 6 | $163 |
| Fisher & Paykel Healthcare Inc | 5 | $161 |
| Axsome Therapeutics, Inc. | 6 | $122 |
| Avadel Specialty Pharmaceuticals, LLC | 1 | $113 |
| Idorsia Pharmaceuticals US Inc | 4 | $73 |
| Philips North America LLC | 4 | $61 |
| Resmed Corp | 2 | $58 |
| AstraZeneca | 3 | $51 |
| Almatica Pharma LLC | 2 | $40 |
| Vanda Pharmaceuticals Inc. | 2 | $38 |
| Inspire Medical Systems, Inc. | 1 | $30 |
| Eisai Inc. | 2 | $29 |
| Merck | 2 | $29 |
| Azurity Pharmaceuticals, Inc. | 2 | $28 |
| Arbor Pharmaceuticals, Inc. | 2 | $23 |
| Itamar Medical Inc | 1 | $22 |
| Sobi, Inc | 1 | $20 |
| Baxter Healthcare | 1 | $17 |
| UCB, Inc. | 1 | $15 |
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
$3,142 in reported general payments places this provider in the 65th percentile of 112 sleep medicine providers in Texas.
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 |
|---|---|---|
| HorizantGabapentin Enacarbil | 16 | $11,214 |
| DayvigoLemborexant | 11 | $3,655 |
| Pramipexole DihydrochloridePramipexole Di-Hcl | 57 | $868 |
| Modafinil | 16 | $622 |
| Zolpidem Tartrate | 109 | $542 |
| Gabapentin | 94 | $528 |
| Ropinirole Hcl | 29 | $361 |
| Estazolam | 12 | $215 |
| Clonazepam | 53 | $179 |
| Trazodone Hcl | 26 | $124 |
| Sertraline Hcl | 12 | $99 |
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 |
|---|---|---|
| Arbor Pharmaceuticals, Inc.Horizant | $23 | $11,21416 claims |
| Eisai Inc.Dayvigo | $29 | $3,65511 claims |
| Almatica Pharma LLCSertraline Hcl | $40 | $9912 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 65th percentile of 112 sleep medicine providers in Texas.
Other sleep medicine in San Antonio
- James AndrySan Antonio$100K
- Karen Hentschel FranksSan Antonio$18K
- Hanul BhandariSan Antonio$10K
- Nici BothwellSan Antonio$3K
- Rafael SantiagoSan Antonio$3K
- Sreejith PillaiSan Antonio$2K
- Gerard MeskillSugar Land$1M
- Vikas JainFrisco$673K
- Amit VermaHouston$493K
- Jerald SimmonsHouston$165K
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.