Deana Mikhalkova, MD
Cardiovascular Disease · St Louis, MONPI 1891016515
Payments from drug & device makers
What this record shows
This record is dominated by food and beverage: $3,609 of the $5,964 with a category attached, or 60.5%. 21 manufacturers reported payments, led by Bridgebio Pharma, Inc. at 25.6% of the total. 2025 is the largest year on record at $2,419, more than ten times the $40 reported in 2019.
Across 106 payments — averaging $56.26 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Bridgebio Pharma, Inc.$2K
- AstraZeneca$1K
- Abbott$676
- Boehringer Ingelheim$454
- Cvrx, Inc.$443
- E.r. Squibb & Sons, L.L.C.$371
- plus $1K from 15 others
Across 322 payments — averaging $1040.69 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.
- Boehringer Ingelheim International GmbH$185K
- Boehringer Ingelheim Pharma GmbH & Co.kg$47K
- E.r. Squibb & Sons, L.L.C.$47K
- Novartis$38K
- AstraZeneca$18K
What the payments were for
- Consulting fees$2,33039%
- Food & beverage$3,60961%
- Education$250%
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 |
|---|---|---|
| Bridgebio Pharma, Inc. | 3 | $1,524 |
| AstraZeneca | 7 | $1,153 |
| Abbott | 16 | $676 |
| Boehringer Ingelheim | 8 | $454 |
| Cvrx, Inc. | 5 | $443 |
| E.r. Squibb & Sons, L.L.C. | 6 | $371 |
| Pfizer | 14 | $262 |
| Abiomed | 6 | $257 |
| Merck | 12 | $204 |
| Novartis | 7 | $124 |
| ZOLL Services LLC (a/k/a ZOLL Lifecor Corp) | 4 | $96 |
| Scpharmaceuticals Inc. | 4 | $89 |
| Boston Scientific | 2 | $73 |
| Lexicon Pharmaceuticals, Inc. | 3 | $55 |
| Sanofi-aventis U.S. LLC | 2 | $41 |
| Impulse Dynamics (USA) Inc. | 2 | $39 |
| Edwards Lifesciences | 1 | $29 |
| Lantheus Medical Imaging, Inc. | 1 | $22 |
| Bayer | 1 | $20 |
| Alnylam Pharmaceuticals Inc. | 1 | $16 |
| Amgen | 1 | $15 |
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.
- Attruby$1,504
- Barostim Neo System$419
- JARDIANCE$362
- CAMZYOS$215
- HeartMate 3 Left Ventricular Assist Device$184
- WAINUA$144
- CARDIOMEMS$124
- Impella$114
- Assurity Pacemaker$110
How this compares
$5,964 in reported general payments places this provider in the 70th percentile of 391 cardiovascular disease providers in Missouri.
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 |
|---|---|---|
| VyndamaxTafamidis | 36 | $1,082,374 |
| EntrestoSacubitril/Valsartan | 122 | $189,170 |
| JardianceEmpagliflozin | 95 | $150,737 |
| EliquisApixaban | 83 | $135,816 |
| FarxigaDapagliflozin Propanediol | 59 | $74,296 |
| Repatha SureclickEvolocumab | 32 | $23,818 |
| VeltassaPatiromer Calcium Sorbitex | 19 | $19,595 |
| XareltoRivaroxaban | 12 | $18,721 |
| Praluent PenAlirocumab | 21 | $9,996 |
| VascepaIcosapent Ethyl | 17 | $5,844 |
| Cyclosporine ModifiedCyclosporine, Modified | 29 | $3,435 |
| Isosorbide Dinit-HydralazineIsosorbide Dinit/Hydralazine | 11 | $2,085 |
| Metoprolol Succinate | 170 | $1,867 |
| Atorvastatin Calcium | 207 | $1,457 |
| Carvedilol | 133 | $1,245 |
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 |
|---|---|---|
| PfizerVyndamax, Eliquis | $262 | $1,218,190119 claims |
| NovartisEntresto | $124 | $189,170122 claims |
| Boehringer IngelheimJardiance | $454 | $150,73795 claims |
| AstraZenecaFarxiga | $1,153 | $74,29659 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 70th percentile of 391 cardiovascular disease providers in Missouri.
Other cardiovascular disease in St Louis
- Paul HauptmanSt Louis$124K
- Bernard ChaitmanSt Louis$121K
- Mikhail KosiborodKansas City$1.1M
- Georges ChahoudSaint Louis$937K
- William BowenSaint Louis$726K
- Daniel KellySaint Louis$582K
- John SpertusKansas City$360K
- James FairlambColumbia$342K
- James EllisonChesterfield$267K
- Osler Jay GuzonSaint Louis$211K
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.