Cynthia Marsh, NP
Nephrology · Johnson City, TNNPI 1407363989
Payments from drug & device makers
What this record shows
This record is dominated by food and beverage: $5,240 of the $8,310 with a category attached, or 63.1%. 26 manufacturers reported payments, led by Amgen at 39.2% of the total. Reporting peaked in 2021 at $3,559 and has fallen 60.1% since, to $1,419 in 2025.
Across 267 payments — averaging $31.12 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Amgen$3K
- AstraZeneca$741
- Akebia Therapeutics Inc$644
- Travere Therapeutics, Inc.$639
- OPKO Pharmaceuticals, LLC$444
- Bayer$384
- plus $2K from 20 others
What the payments were for
- Speaking & faculty fees$2,97536%
- Food & beverage$5,24063%
- Education$951%
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 |
|---|---|---|
| Amgen(2 entities) | 16 | $3,260 |
| AstraZeneca(2 entities) | 39 | $741 |
| Akebia Therapeutics Inc | 18 | $644 |
| Travere Therapeutics, Inc. | 31 | $639 |
| OPKO Pharmaceuticals, LLC | 44 | $444 |
| Bayer | 24 | $384 |
| Calliditas Therapeutics US Inc. | 8 | $302 |
| Vifor Pharma, Inc. | 11 | $260 |
| Fresenius USA Marketing, Inc. | 14 | $248 |
| Mallinckrodt Hospital Products Inc. | 7 | $243 |
| Novartis | 11 | $238 |
| Aurinia Pharma U.S., Inc. | 11 | $220 |
| Daiichi Sankyo Inc. | 9 | $186 |
| Otsuka America Pharmaceutical, Inc. | 9 | $147 |
| Nxstage Medical, Inc. | 2 | $108 |
| Ardelyx, Inc. | 2 | $38 |
| GSK | 2 | $32 |
| Alnylam Pharmaceuticals Inc. | 1 | $27 |
| Kyowa Kirin, Inc. | 1 | $23 |
| Scpharmaceuticals Inc. | 1 | $23 |
| Xeris Pharmaceuticals, Inc. | 1 | $21 |
| Pfizer | 1 | $20 |
| Medline Industries LP | 1 | $17 |
| Novo Nordisk | 1 | $17 |
| Shield Therapeutics Inc | 1 | $15 |
| Pharmacosmos Therapeutics Inc. | 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.
How this compares
$8,310 in reported general payments places this provider in the 80th percentile of 229 nephrology providers in Tennessee.
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 |
|---|---|---|
| XphozahTenapanor Hcl | 63 | $279,395 |
| VelphoroSucroferric Oxyhydroxide | 50 | $169,506 |
| AuryxiaFerric Citrate | 45 | $57,964 |
| VeltassaPatiromer Calcium Sorbitex | 38 | $36,511 |
| LokelmaSodium Zirconium Cyclosilicate | 30 | $28,333 |
| Sevelamer Carbonate | 150 | $22,840 |
| Lanthanum Carbonate | 20 | $14,266 |
| ClinisolParenteral Amino Acid 15% No.5 | 51 | $10,269 |
| EliquisApixaban | 11 | $5,817 |
| Calcium Acetate | 40 | $2,896 |
| Midodrine Hcl | 38 | $2,423 |
| Lidocaine-PrilocaineLidocaine/Prilocaine | 70 | $1,726 |
| Torsemide | 19 | $722 |
| Ondansetron Hcl | 31 | $501 |
| Furosemide | 67 | $391 |
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 |
|---|---|---|
| Fresenius USA Marketing, Inc.Velphoro | $248 | $169,50650 claims |
| Akebia Therapeutics IncAuryxia | $644 | $57,96445 claims |
| AstraZenecaLokelma | $741 | $28,33330 claims |
| PfizerEliquis | $20 | $5,81711 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 80th percentile of 229 nephrology providers in Tennessee.
Other nephrology in Johnson City
- Lara KfouryJohnson City$10K
- Martin TranJohnson City$9K
- Samardia MissickJohnson City$6K
- Jamie DwyerNashville$461K
- Ross NesbitKnoxville$452K
- Gerald BorrelliKnoxville$190K
- Volker HaaseNashville$123K
- Chike NzerueCookeville$95K
- Talat IkizlerNashville$93K
- Omar HamzeMemphis$90K
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.