Bernard Grunstra, MD
Internal Medicine · Bristol, TNNPI 1558367417
Payments from drug & device makers
What this record shows
This record is dominated by food and beverage: $10,479 of the $15,767 with a category attached, or 66.5%. It is spread thinly across 41 manufacturers, the largest accounting for just 21.2%. Among internal medicine clinicians in TN with any reported payments, this total sits in the top 5% — high for the specialty, which is a reason to read the composition above rather than the number alone.
Across 607 payments — averaging $25.97 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- AstraZeneca$3K
- F. Hoffmann-la Roche AG$2K
- Boehringer Ingelheim International GmbH$2K
- Modernatx, Inc.$2K
- AbbVie$1K
- Novo Nordisk$926
- plus $6K from 35 others
Across 959 payments — averaging $6719.39 each. Payments tied to a research study. These frequently flow through the physician to a hospital or research institution rather than to the physician personally.
- Pfizer$1.9M
- Regeneron$862K
- Johnson & Johnson$781K
- Modernatx, Inc.$533K
- Boehringer Ingelheim$514K
- Novavax Inc$476K
- plus $1.4M from 13 others
What the payments were for
- Travel & lodging$5,26733%
- Food & beverage$10,47966%
- Education$210%
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.
How this compares
$15,767 in reported general payments places this provider in the 95th percentile of 2,216 internal medicine providers in Tennessee.
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 |
|---|---|---|
| OzempicSemaglutide | 84 | $129,268 |
| FarxigaDapagliflozin Propanediol | 134 | $125,045 |
| EliquisApixaban | 105 | $116,420 |
| JardianceEmpagliflozin | 72 | $67,068 |
| Trelegy ElliptaFluticasone/Umeclidin/Vilanter | 66 | $66,843 |
| MounjaroTirzepatide | 55 | $55,522 |
| Soliqua 100-33Insulin Glargine/Lixisenatide | 38 | $46,847 |
| TrulicityDulaglutide | 29 | $46,004 |
| XareltoRivaroxaban | 51 | $36,422 |
| RybelsusSemaglutide | 21 | $28,843 |
| EntrestoSacubitril/Valsartan | 24 | $28,788 |
| Repatha SureclickEvolocumab | 31 | $25,900 |
| VascepaIcosapent Ethyl | 34 | $18,377 |
| Anoro ElliptaUmeclidinium Brm/Vilanterol Tr | 22 | $16,569 |
| LinzessLinaclotide | 18 | $15,845 |
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 |
|---|---|---|
| Novo NordiskOzempic, Rybelsus | $926 | $158,111105 claims |
| AstraZenecaFarxiga | $3,345 | $125,045134 claims |
| PfizerEliquis | $328 | $116,420105 claims |
| Lilly USA, LLCMounjaro, Trulicity | $368 | $101,52684 claims |
| GSKTrelegy Ellipta, Anoro Ellipta, Breo Ellipta | $881 | $88,417101 claims |
| Boehringer IngelheimJardiance, Glyxambi, Synjardy Xr | $331 | $87,07196 claims |
| Sanofi-aventis U.S. LLCSoliqua 100-33 | $347 | $46,84738 claims |
| Johnson & JohnsonXarelto | $242 | $36,42251 claims |
| NovartisEntresto | $247 | $28,78824 claims |
| AbbVieLinzess, Synthroid | $1,042 | $19,44169 claims |
| Esperion Therapeutics, Inc.Nexlizet | $153 | $8,29516 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 95th percentile of 2,216 internal medicine providers in Tennessee.
Other internal medicine in Bristol
- Nathan GargusBristol$22K
- John AndersonNashville$1.5M
- Tracie WalkerJackson$488K
- Nathan TrenthamEtowah$404K
- Dennis DeruelleKnoxville$263K
- Devin ShermanFranklin$191K
- Lewis HagoodKnoxville$143K
- Temidayo AbeNashville$113K
- Kenya KozawaSweetwater$86K
- Wayne RileyNashville$86K
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.