David Nesheim, MD
Critical Care Medicine · Olympia, WANPI 1205253481
Payments from drug & device makers
What this record shows
This record is dominated by education: $3,057 of the $4,072 with a category attached, or 75.1%. Intuitive Surgical accounts for 89.3% of it on its own, with 5 other manufacturers making up the rest. Reporting peaked in 2023 at $3,751 and has fallen 97.9% since, to $80 in 2025. Among critical care medicine clinicians in WA 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 27 payments — averaging $150.80 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Intuitive Surgical$4K
- Sanofi$280
- Sanofi-aventis U.S. LLC$57
- Regeneron Healthcare Solutions, Inc.$52
- GSK$28
- AstraZeneca$18
What the payments were for
- Travel & lodging$57314%
- Food & beverage$44111%
- Education$3,05775%
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 |
|---|---|---|
| Intuitive Surgical | 7 | $3,638 |
| Sanofi | 14 | $280 |
| Sanofi-aventis U.S. LLC | 1 | $57 |
| Regeneron Healthcare Solutions, Inc. | 3 | $52 |
| GSK | 1 | $28 |
| AstraZeneca | 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.
- ION$3,000
- Da Vinci Surgical System$554
How this compares
$4,072 in reported general payments places this provider in the 90th percentile of 115 critical care medicine providers in Washington.
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 | 89 | $65,768 |
| Anoro ElliptaUmeclidinium Brm/Vilanterol Tr | 136 | $64,796 |
| Stiolto RespimatTiotropium Br/Olodaterol Hcl | 111 | $61,436 |
| Spiriva RespimatTiotropium Bromide | 66 | $44,187 |
| Spiriva HandihalerTiotropium Bromide | 67 | $43,951 |
| Breo ElliptaFluticasone/Vilanterol | 76 | $38,939 |
| Incruse ElliptaUmeclidinium Bromide | 93 | $31,773 |
| Advair HfaFluticasone Propion/Salmeterol | 44 | $18,820 |
| Fluticasone-SalmeterolFluticasone Propion/Salmeterol | 142 | $18,202 |
| Tiotropium Bromide | 40 | $13,162 |
| Arnuity ElliptaFluticasone Furoate | 41 | $10,943 |
| SymbicortBudesonide/Formoterol Fumarate | 30 | $9,232 |
| Albuterol Sulfate HfaAlbuterol Sulfate | 221 | $6,200 |
| Qvar RedihalerBeclomethasone Dipropionate | 22 | $5,596 |
| DuleraMometasone/Formoterol | 11 | $4,165 |
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, Anoro Ellipta, Breo Ellipta, Incruse Ellipta, Arnuity Ellipta | $28 | $212,220435 claims |
| AstraZenecaSymbicort | $18 | $9,23230 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 115 critical care medicine providers in Washington.
Other critical care medicine in Olympia
- Leslie Jette-KellyOlympia$919
- Vinay GuptaSeattle$185K
- Sara NikravanSeattle$106K
- Michael SouterSeattle$20K
- Ravinder ShergillVancouver$16K
- Oliver McElvaneySeattle$7K
- Sharukh LokhandwalaSeattle$7K
- Kurt JensenTacoma$6K
- Raquel BartzSeattle$5K
- Chelsea GarnerTacoma$5K
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.