Douglas Palma, MD
Orthopaedic Surgery · Wilmington, DENPI 1215977764
Payments from drug & device makers
What this record shows
This record is dominated by education: $3,909 of the $6,222 with a category attached, or 62.8%. Arthrex accounts for 65.9% of it on its own, with 10 other manufacturers making up the rest. Reporting peaked in 2020 at $2,979 and has fallen 98.5% since, to $44 in 2025. That places this record below the midpoint for orthopaedic surgery clinicians in DE, where the typical reported total is $6,222.
Across 59 payments — averaging $105.47 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Arthrex$4K
- Liberty Surgical Inc.$2K
- Eclipse Technology Solutions Inc.$171
- Stryker$113
- Amgen$97
- Zimmer Biomet$70
- plus $145 from 5 others
What the payments were for
- Travel & lodging$92315%
- Food & beverage$1,39022%
- Education$3,90963%
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 |
|---|---|---|
| Arthrex | 20 | $4,103 |
| Liberty Surgical Inc. | 12 | $1,522 |
| Eclipse Technology Solutions Inc. | 9 | $171 |
| Stryker | 4 | $113 |
| Amgen | 7 | $97 |
| Zimmer Biomet | 1 | $70 |
| Smith+Nephew | 2 | $57 |
| Johnson & Johnson | 1 | $26 |
| Mimedx Group, Inc. | 1 | $26 |
| Pacira Pharmaceuticals Incorporated | 1 | $18 |
| Orthofix Medical, Inc. | 1 | $18 |
How this compares
$6,222 in reported general payments places this provider in the 50th percentile of 70 orthopaedic surgery providers in Delaware.
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 |
|---|---|---|
| PennsaidDiclofenac Sodium | 14 | $35,008 |
| Oxycodone Hcl | 30 | $195 |
| Ibuprofen | 41 | $168 |
| Naproxen | 28 | $103 |
| Cephalexin | 32 | $68 |
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 |
|---|---|---|
| AmgenPennsaid | $97 | $35,00814 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 50th percentile of 70 orthopaedic surgery providers in Delaware.
Other orthopaedic surgery in Wilmington
- Suken ShahWilmington$2.1M
- Patrick WardWilmington$68K
- Steven DelloseWilmington$52K
- James RubanoWilmington$39K
- Nicholas QuercettiWilmington$32K
- Michael PrincipeWilmington$29K
- David TainterWilmington$26K
- Akul PatelWilmington$21K
- Alfonso ArevaloWilmington$18K
- Michael ShraderWilmington$14K
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.