Brian Fletcher, MD
Vascular Surgery · Florence, ALNPI 1285900597
Payments from drug & device makers
What this record shows
This record is dominated by food and beverage: $2,836 of the $3,859 with a category attached, or 73.5%. 21 manufacturers reported payments, led by Silk Road Medical, Inc. at 30.2% of the total. Reporting peaked in 2019 at $2,125 and has fallen 78.4% since, to $458 in 2025. That places this record below the midpoint for vascular surgery clinicians in AL, where the typical reported total is $5,256.
Across 104 payments — averaging $37.10 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Silk Road Medical, Inc.$1K
- Cook Medical LLC$787
- Medtronic$617
- Penumbra, Inc.$216
- Bard Peripheral Vascular, Inc.$203
- Kerecis Limited$170
- plus $702 from 15 others
What the payments were for
- Grants$3038%
- Travel & lodging$67217%
- Food & beverage$2,83674%
- Education$471%
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 |
|---|---|---|
| Silk Road Medical, Inc. | 19 | $1,164 |
| Cook Medical LLC | 25 | $787 |
| Medtronic(2 entities) | 14 | $617 |
| Penumbra, Inc. | 4 | $216 |
| Bard Peripheral Vascular, Inc. | 10 | $203 |
| Kerecis Limited | 5 | $170 |
| Endologix LLC | 3 | $116 |
| Getinge USA Sales, LLC | 3 | $105 |
| Lemaitre Vascular, Inc. | 5 | $72 |
| Inari Medical, Inc. | 2 | $62 |
| Stryker | 2 | $49 |
| Boston Scientific | 2 | $41 |
| Elutia, Inc. | 1 | $41 |
| Veryan Medical Incorporated | 1 | $39 |
| Bsn Medical Inc | 2 | $36 |
| Smith+Nephew | 1 | $34 |
| Solventum Corporation | 1 | $24 |
| Reflow Medical Inc | 1 | $23 |
| Shockwave Medical, Inc | 1 | $22 |
| Abiomed | 1 | $18 |
| Tactile Systems Technology Inc | 1 | $18 |
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
$3,859 in reported general payments places this provider in the 40th percentile of 61 vascular surgery providers in Alabama.
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 |
|---|---|---|
| EliquisApixaban | 82 | $49,672 |
| XareltoRivaroxaban | 44 | $42,286 |
| BrilintaTicagrelor | 22 | $11,864 |
| Atorvastatin Calcium | 122 | $1,290 |
| Enoxaparin Sodium | 11 | $983 |
| Pentoxifylline | 17 | $885 |
| ClopidogrelClopidogrel Bisulfate | 78 | $692 |
| Hydrocodone-AcetaminophenHydrocodone/Acetaminophen | 89 | $267 |
| Rosuvastatin Calcium | 13 | $47 |
| Sulfamethoxazole-TrimethoprimSulfamethoxazole/Trimethoprim | 14 | $38 |
Paid to pharmacies, not to this prescriber.
Other vascular surgery in Florence
- Peter PonsFlorence$54K
- Albert PacificoBirmingham$5.1M
- Andrew KnottHuntsville$76K
- Brian SellersMontgomery$71K
- Benjamin PearceBirmingham$37K
- William HolmanBirmingham$25K
- Keenan WanamakerMontgomery$23K
- Marco CioppiHuntsville$21K
- Mina JacobMobile$19K
- Stephen HeinzmanBirmingham$18K
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.