Carl Smart, MD
Pulmonary Disease · Monroe, NCNPI 1518986652
Payments from drug & device makers
What this record shows
This record is dominated by speaking fees: $23,250 of the $33,954 with a category attached, or 68.5%. AstraZeneca accounts for 81.2% of it on its own, with 37 other manufacturers making up the rest. Reporting peaked in 2021 at $12,225 and has fallen 81.6% since, to $2,248 in 2025. Among pulmonary disease clinicians in NC with any reported payments, this total sits in the top 10% — high for the specialty, which is a reason to read the composition above rather than the number alone.
Across 392 payments — averaging $86.62 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- AstraZeneca$28K
- GSK$2K
- Amgen$848
- Sanofi$803
- Mylan Specialty L.p.$355
- Regeneron Healthcare Solutions, Inc.$312
- plus $2K from 32 others
Across 2 payments — averaging $4350.00 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.
- Insmed, Inc.$9K
What the payments were for
- Consulting fees$1,6855%
- Speaking & faculty fees$23,25068%
- Travel & lodging$1060%
- Food & beverage$8,79926%
- Education$1130%
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 |
|---|---|---|
| AstraZeneca | 85 | $27,563 |
| GSK | 79 | $1,634 |
| Amgen | 62 | $848 |
| Sanofi | 28 | $803 |
| Mylan Specialty L.p. | 11 | $355 |
| Regeneron Healthcare Solutions, Inc. | 10 | $312 |
| Philips North America LLC | 16 | $302 |
| Insmed, Inc. | 10 | $195 |
| Mallinckrodt Hospital Products Inc. | 4 | $174 |
| Baxter Healthcare | 7 | $169 |
| Grifols USA, LLC | 8 | $157 |
| ANI Pharmaceuticals, Inc. | 7 | $151 |
| Actelion Pharmaceuticals US, Inc. | 5 | $119 |
| Takeda Pharmaceuticals U.S.A., Inc. | 4 | $116 |
| Inspire Medical Systems, Inc. | 4 | $113 |
| Inogen, Inc. | 6 | $112 |
| Boehringer Ingelheim | 5 | $105 |
| Novartis | 4 | $85 |
| Paratek Pharmaceuticals, Inc. | 5 | $79 |
| Genentech USA, Inc. | 4 | $67 |
| E.r. Squibb & Sons, L.L.C. | 4 | $56 |
| Advanced Respiratory, Inc | 2 | $45 |
| Pulmonx Corporation | 2 | $40 |
| Lilly USA, LLC | 2 | $39 |
| Phadia US Inc. | 2 | $39 |
| Aytu Biopharma, Inc. | 2 | $36 |
| Electromed, Inc. | 2 | $30 |
| Verona Pharma, Inc. | 2 | $27 |
| CSL Behring | 1 | $24 |
| Viatris Specialty LLC | 1 | $23 |
| Vifor Pharma, Inc. | 1 | $22 |
| Hikma Pharmaceuticals USA | 1 | $20 |
| Bayer | 1 | $19 |
| Nabriva Therapeutics, PLC | 1 | $17 |
| Circassia Inc. | 1 | $16 |
| Tactile Systems Technology Inc | 1 | $14 |
| Resmed Corp | 1 | $13 |
| Mylan Pharmaceuticals Inc. | 1 | $12 |
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.
- BREZTRI$18,758
- BREZTRI AEROSPHERE$7,166
- TEZSPIRE$721
- AIRSUPRA$269
- FASENRA$269
- DUPIXENT$261
- NUCALA$245
- TRELEGY ELLIPTA$121
- Yupelri$120
How this compares
$33,954 in reported general payments places this provider in the 90th percentile of 393 pulmonary disease providers in North 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 |
|---|---|---|
| Trelegy ElliptaFluticasone/Umeclidin/Vilanter | 894 | $711,165 |
| OpsumitMacitentan | 36 | $454,756 |
| TezspireTezepelumab-Ekko | 45 | $189,935 |
| Breztri AerosphereBudesonide/Glycopyr/Formoterol | 246 | $178,986 |
| Ambrisentan | 77 | $172,140 |
| LetairisAmbrisentan | 12 | $156,086 |
| ZemairaAlpha-1-Proteinase Inhibitor | 12 | $127,629 |
| Breo ElliptaFluticasone/Vilanterol | 210 | $115,565 |
| NucalaMepolizumab | 20 | $73,799 |
| Orenitram ErTreprostinil Diolamine | 18 | $51,628 |
| SymbicortBudesonide/Formoterol Fumarate | 112 | $31,528 |
| Stiolto RespimatTiotropium Br/Olodaterol Hcl | 47 | $31,002 |
| Spiriva RespimatTiotropium Bromide | 33 | $26,626 |
| Anoro ElliptaUmeclidinium Brm/Vilanterol Tr | 51 | $25,469 |
| EliquisApixaban | 24 | $20,307 |
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 |
|---|---|---|
| GSKTrelegy Ellipta, Breo Ellipta, Nucala, Anoro Ellipta, Arnuity Ellipta | $1,634 | $941,9561,218 claims |
| Actelion Pharmaceuticals US, Inc.Opsumit | $119 | $454,75636 claims |
| AstraZenecaTezspire, Breztri Aerosphere, Symbicort, Airsupra | $27,563 | $407,710419 claims |
| CSL BehringZemaira | $24 | $127,62912 claims |
| Boehringer IngelheimStiolto Respimat, Spiriva Respimat, Combivent Respimat | $105 | $73,875112 claims |
| Hikma Pharmaceuticals USAEpinephrine | $20 | $3,20115 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 90th percentile of 393 pulmonary disease providers in North Carolina.
Other pulmonary disease in Monroe
- Michael PritchettPinehurst$1.3M
- Michael WertGreensboro$412K
- Eugene BleeckerWinston Salem$357K
- Bradley IcardPinehurst$299K
- James DonohueChapel Hill$271K
- Eric MeltzerDurham$262K
- Daniel BreaultWilmington$257K
- Scott SkiboPinehurst$229K
- Jill OharWinston Salem$226K
- Priyank DesaiRocky Mount$199K
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.