Brian Ralph, DPM
Foot Surgery · Charleston, SCNPI 1154306181
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 100.0% of the total across 29 separate payments, which is the pattern of a clinician who attends manufacturer presentations rather than one with a consulting arrangement. 12 manufacturers reported payments, led by Stryker at 55.9% of the total. Reporting peaked in 2024 at $332 and has fallen 50.3% since, to $165 in 2025.
Across 29 payments — averaging $46.28 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Stryker$750
- Alafair Biosciences, Inc.$186
- Kerecis Limited$94
- Treace Medical Concepts, Inc.$80
- Bioventus LLC$51
- KCI USA, Inc.$48
- plus $133 from 6 others
What the payments were for
- Food & beverage$1,342100%
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 |
|---|---|---|
| Stryker(2 entities) | 7 | $750 |
| Alafair Biosciences, Inc. | 1 | $186 |
| Kerecis Limited | 6 | $94 |
| Treace Medical Concepts, Inc. | 4 | $80 |
| Bioventus LLC | 2 | $51 |
| KCI USA, Inc. | 2 | $48 |
| Smith+Nephew | 2 | $42 |
| Globus Medical | 1 | $22 |
| Nevro Corp. | 1 | $22 |
| Mimedx Group, Inc. | 1 | $19 |
| Amgen | 1 | $14 |
| Forte Bio-pharma LLC | 1 | $13 |
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.
- CARTIVA$230
- VersaWrap$186
- ORTHOLOC 3DI$172
- AUGMENT INJECTABLE$172
- ACTISHIELD CF$127
How this compares
$1,342 in reported general payments places this provider in the 65th percentile of 28 foot surgery providers in South Carolina.
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 |
|---|---|---|
| Piroxicam | 19 | $10,550 |
| Calcipotriene | 26 | $8,621 |
| XareltoRivaroxaban | 21 | $5,302 |
| Fluconazole | 86 | $1,554 |
| Ammonium Lactate | 52 | $1,364 |
| Ibuprofen | 102 | $838 |
| Cephalexin | 111 | $704 |
| Ondansetron Hcl | 120 | $673 |
| Pregabalin | 30 | $671 |
| Oxycodone-AcetaminophenOxycodone Hcl/Acetaminophen | 91 | $624 |
| Ketoconazole | 24 | $588 |
| Clotrimazole-BetamethasoneClotrimazole/Betamethasone Dip | 23 | $577 |
| Triamcinolone Acetonide | 35 | $551 |
| Methylprednisolone | 91 | $541 |
| Gabapentin | 79 | $514 |
Paid to pharmacies, not to this prescriber.
Other foot surgery in Charleston
- Jeffrey ArmstrongCharleston$4K
- Katherine PrattCharleston$1K
- Maureen QuinlanColumbia$46K
- Jordanna BakerFlorence$36K
- Christopher CrabtreeRock Hill$11K
- Amanda WarnerColumbia$9K
- George SichAiken$6K
- Heather DriessenColumbia$3K
- David NegronSpartanburg$2K
- James RoseAnderson$2K
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.