Efrem Cox, MD
Neurological Surgery · Las Vegas, NVNPI 1841581527
Payments from drug & device makers
What this record shows
The money is spread across several categories — consulting fees (52.1%), food and beverage and travel and lodging — rather than concentrated in one kind of arrangement. 25 manufacturers reported payments, led by Stryker at 56.2% of the total. Reporting peaked in 2022 at $17,957 and has fallen 86.8% since, to $2,376 in 2025.
Across 433 payments — averaging $103.24 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Stryker$25K
- Johnson & Johnson$6K
- Globus Medical$4K
- Providence Medical Technology, Inc.$3K
- Medical Device Business Services, Inc.$2K
- Spineology Inc.$629
- plus $4K from 19 others
What the payments were for
- Consulting fees$23,30052%
- Speaking & faculty fees$2321%
- Travel & lodging$4,53210%
- Food & beverage$16,63837%
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 |
|---|---|---|
| Stryker | 43 | $25,128 |
| Johnson & Johnson | 285 | $6,043 |
| Globus Medical(2 entities) | 17 | $4,097 |
| Providence Medical Technology, Inc. | 34 | $2,588 |
| Medical Device Business Services, Inc. | 8 | $2,436 |
| Spineology Inc. | 2 | $629 |
| Pacira Pharmaceuticals Incorporated | 5 | $589 |
| Icotec Medical Inc. | 4 | $485 |
| Medtronic(2 entities) | 8 | $432 |
| Kls-martin L.p. | 3 | $393 |
| Aesculap, Inc. | 3 | $316 |
| Nevro Corp. | 3 | $219 |
| Integrity Implants Inc. Dba Accelus | 1 | $210 |
| Si-bone, Inc. | 3 | $204 |
| Lifenet Health | 2 | $186 |
| Biotronik NRO, Inc. | 3 | $175 |
| Irras USA, Inc. | 1 | $146 |
| Arthrex | 1 | $132 |
| Spineart USA Inc | 1 | $129 |
| Integra Lifesciences Corporation | 1 | $60 |
| Goode Surgical Inc | 1 | $38 |
| Livanova USA, Inc. | 1 | $25 |
| Boston Scientific | 1 | $19 |
| Abbott | 1 | $15 |
| Biocomposites Inc | 1 | $6 |
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.
- NIAGARA LATERAL ACCESS SYSTEM$9,000
- CASCADIA INTERBODY SYSTEM$6,883
- ES2 SPINAL SYSTEM$6,000
- TRITANIUM$6,000
- XIA 3$6,000
- RAVINE LATERAL ACCESS SYSTEM$6,000
- EVEREST SPINAL SYSTEM$4,167
- Excelsius Robotics System$1,464
- Excelsius - GPS$1,199
- VIPER$598
- EXPAREL$492
- CONDUIT$484
- XLIF$456
- Rampart Duo Ti Interbody Fusion System$442
- MONTEREY AL$426
- ALIF$418
- EXPEDIUM$334
- CAPRI$295
- CASCADIA$286
- SERRATO$266
How this compares
$44,702 in reported general payments places this provider in the 75th percentile of 45 neurological surgery providers in Nevada.
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 |
|---|---|---|
| Gabapentin | 140 | $1,220 |
| Methocarbamol | 124 | $1,200 |
| Meloxicam | 268 | $584 |
| Oxycodone-AcetaminophenOxycodone Hcl/Acetaminophen | 12 | $152 |
| Pregabalin | 13 | $125 |
| Cyclobenzaprine Hcl | 11 | $90 |
| Tizanidine Hcl | 11 | $47 |
Paid to pharmacies, not to this prescriber.
Other neurological surgery in Las Vegas
- William SmithLas Vegas$1.5M
- Jason GarberLas Vegas$787K
- Yevgeniy KhavkinLas Vegas$577K
- Michael SeiffLas Vegas$335K
- Scott GlickmanLas Vegas$274K
- Gregory DoudsLas Vegas$29K
- Michael SchneierLas Vegas$21K
- John AnsonLas Vegas$18K
- Angela PalmerLas Vegas$13K
- Gary FlangasLas Vegas$7K
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.