RxDoctor Payments Data

Bhaja Shrestha, MD

Pulmonary Disease · Bismarck, NDNPI 1831354679

Payments from drug & device makers

What this record shows

The money is spread across several categories — education (41.3%), food and beverage and travel and lodging — rather than concentrated in one kind of arrangement. Intuitive Surgical accounts for 67.7% of it on its own, with 38 other manufacturers making up the rest. Reporting peaked in 2024 at $7,038 and has fallen 86.6% since, to $941 in 2025.

$9,725in general payments, 2019–2025

Across 203 payments — averaging $47.91 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.

  • Intuitive Surgical$7K
  • GSK$414
  • AbbVie$301
  • Inspire Medical Systems, Inc.$261
  • AstraZeneca$232
  • United Therapeutics Corporation$212
  • plus $2K from 33 others

What the payments were for

  • Travel & lodging$1,84719%
  • Food & beverage$3,85740%
  • Education$4,01341%
  • Gifts$90%

General payments by program year

19
20
21
22
23
24
25

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

$9,725 in reported general payments places this provider in the 85th percentile of 31 pulmonary disease providers in North Dakota.

See all pulmonary disease providers in North Dakota

Medicare billing

Part B allowed, 2024
$89,426
Medicare patients
364
Services billed
1,004

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

DrugClaimsCost to plans & patients
Aralast NpAlpha-1-Proteinase Inhibitor13$139,574
Trelegy ElliptaFluticasone/Umeclidin/Vilanter69$51,439
Breo ElliptaFluticasone/Vilanterol43$24,119
Spiriva RespimatTiotropium Bromide35$22,807
SymbicortBudesonide/Formoterol Fumarate35$7,934
Advair HfaFluticasone Propion/Salmeterol15$4,611
Fluticasone-SalmeterolFluticasone Propion/Salmeterol11$2,094
Albuterol Sulfate HfaAlbuterol Sulfate53$2,079
Budesonide-Formoterol FumarateBudesonide/Formoterol Fumarate13$1,900
Roflumilast17$623
Ventolin HfaAlbuterol Sulfate11$587
Montelukast Sodium25$239

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.

CompanyPaid to this providerPart D cost of their drugs
GSKTrelegy Ellipta, Breo Ellipta$414$75,559112 claims
Boehringer IngelheimSpiriva Respimat$95$22,80735 claims
AstraZenecaSymbicort$232$7,93435 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 85th percentile of 31 pulmonary disease providers in North Dakota.

Other pulmonary disease in Bismarck

See the full list for North Dakota

Where these figures come from

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