Brian Handal, DO
Orthopaedic Surgery of the Spine · West Des Moines, IANPI 1144727835
Payments from drug & device makers
What this record shows
The money is spread across several categories — consulting fees (58.0%), travel and lodging and food and beverage — rather than concentrated in one kind of arrangement. 28 manufacturers reported payments, led by Carlsmed, Inc. at 59.2% of the total. 2025 is the largest year on record at $61,533, more than ten times the $1,969 reported in 2019.
Across 227 payments — averaging $403.58 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Carlsmed, Inc.$54K
- Alphatec Spine, Inc$22K
- CDC Medical LLC$3K
- Ossdsign USA Incorporated$3K
- Si-bone, Inc.$2K
- Orthofix Medical, Inc.$1K
- plus $6K from 22 others
What the payments were for
- Consulting fees$53,10558%
- Travel & lodging$23,49426%
- Food & beverage$11,49113%
- Education$3,5234%
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 |
|---|---|---|
| Carlsmed, Inc. | 36 | $54,263 |
| Alphatec Spine, Inc | 78 | $21,985 |
| CDC Medical LLC | 5 | $3,237 |
| Ossdsign USA Incorporated | 3 | $2,603 |
| Si-bone, Inc. | 16 | $2,109 |
| Orthofix Medical, Inc. | 12 | $1,147 |
| Zimmer Biomet | 8 | $1,080 |
| Stryker | 13 | $796 |
| Boston Scientific | 11 | $686 |
| Cerapedics Inc. | 9 | $626 |
| Acumed LLC | 1 | $567 |
| Smith+Nephew | 9 | $450 |
| Globus Medical(2 entities) | 5 | $379 |
| Abbott | 2 | $263 |
| Amplify Surgical, Inc. | 2 | $249 |
| Providence Medical Technology, Inc. | 2 | $214 |
| Johnson & Johnson | 1 | $150 |
| Medtronic | 3 | $148 |
| Augmedics Inc. | 1 | $129 |
| Sanara Medtech Inc. | 1 | $95 |
| KCI USA, Inc. | 1 | $73 |
| Skeletal Dynamics Inc | 1 | $70 |
| Mallinckrodt Enterprises LLC | 1 | $67 |
| Mallinckrodt Hospital Products Inc. | 1 | $63 |
| Medical Device Business Services, Inc. | 2 | $46 |
| Pacira Pharmaceuticals Incorporated | 1 | $46 |
| Baxter Healthcare | 1 | $38 |
| Prism Medical | 1 | $35 |
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.
- aprevo$53,563
- Other - Miscellaneous$15,193
- SafeOp$3,500
- OssDsign Catalyst$2,500
- ACUMED$2,267
- M6-C$676
- iFuse Implant$665
- Xvision$644
- WaveWriter Alpha Prime 16$408
- I-FACTOR PEPTIDE ENHANCED BONE GRAFT$369
- Identity$318
- Solus ALIF$261
- dualX and DualPortal$249
- ASCENT;ASCENT LE;FIREBIRD SFS;ICON SFS;SFS$181
- Comprehensive Shoulder System$173
- Senza$167
- Teligen$150
- Bone Anchors with Arthroscopic Delivery System$143
- Healicoil$143
- ETERNA$142
How this compares
Too few orthopaedic surgery of the spine providers in Iowato place this figure against a meaningful peer group, so we don't.
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 |
|---|---|---|
| Pregabalin | 36 | $702 |
| Oxycodone Hcl | 73 | $436 |
| Methocarbamol | 18 | $279 |
| Mupirocin | 43 | $255 |
| Ondansetron Hcl | 36 | $211 |
| Methylprednisolone | 14 | $69 |
| Ibuprofen | 15 | $55 |
| Tramadol Hcl | 24 | $54 |
Paid to pharmacies, not to this prescriber.
Other orthopaedic surgery of the spine in West Des Moines
- Mitchell HughesWest Des Moines$9K
- Andrew PugelyIowa City$208K
- Joshua BarberCedar Rapids$112K
- Catherine OlingerIowa City$51K
- Mark PalitClarion$19K
- Zaki IbrahimClive$19K
- Evan LarsonIowa City$9K
- Michael ChapmanDubuque$9K
- Trevor SchmitzDes Moines$6K
- Benjamin MaclennanNorth Liberty$4K
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.