Essam Elkady, MD
Sleep Medicine · Joplin, MONPI 1124125190
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 96.6% of the total across 205 separate payments, which is the pattern of a clinician who attends manufacturer presentations rather than one with a consulting arrangement. It is spread thinly across 29 manufacturers, the largest accounting for just 20.3% — the pattern of someone who eats at a lot of different presentations. Reporting peaked in 2019 at $1,907 and has fallen 81.1% since, to $361 in 2025.
Across 205 payments — averaging $17.01 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- GSK$709
- Boehringer Ingelheim$620
- AstraZeneca$541
- Regeneron Healthcare Solutions, Inc.$250
- Harmony Biosciences LLC$172
- Actelion Pharmaceuticals US, Inc.$150
- plus $1K from 23 others
What the payments were for
- Food & beverage$3,37097%
- Education$1173%
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 |
|---|---|---|
| GSK | 56 | $709 |
| Boehringer Ingelheim | 36 | $620 |
| AstraZeneca | 22 | $541 |
| Regeneron Healthcare Solutions, Inc. | 11 | $250 |
| Harmony Biosciences LLC | 4 | $172 |
| Actelion Pharmaceuticals US, Inc. | 8 | $150 |
| Novartis | 8 | $133 |
| Genentech USA, Inc. | 10 | $129 |
| Mylan Specialty L.p. | 9 | $122 |
| Sanofi | 4 | $108 |
| United Therapeutics Corporation | 4 | $54 |
| Shire North American Group Inc | 3 | $51 |
| Johnson & Johnson | 3 | $50 |
| Pfizer | 3 | $43 |
| Grifols USA, LLC | 3 | $39 |
| AbbVie | 3 | $39 |
| Jazz Pharmaceuticals Inc. | 2 | $35 |
| Sunovion Pharmaceuticals Inc. | 3 | $32 |
| Insmed, Inc. | 2 | $31 |
| Takeda Pharmaceuticals U.S.A., Inc. | 1 | $30 |
| Philips North America LLC | 2 | $26 |
| Baxter Healthcare | 1 | $19 |
| Circassia Inc. | 1 | $18 |
| Inspire Medical Systems, Inc. | 1 | $18 |
| Merck | 1 | $16 |
| Pulmonx Corporation | 1 | $14 |
| Astellas Pharma US Inc | 1 | $14 |
| Apria Healthcare LLC | 1 | $13 |
| Electromed, Inc. | 1 | $11 |
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
$3,488 in reported general payments places this provider in the 80th percentile of 33 sleep medicine 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 |
|---|---|---|
| OfevNintedanib Esylate | 27 | $356,012 |
| Trelegy ElliptaFluticasone/Umeclidin/Vilanter | 150 | $130,715 |
| Aralast NpAlpha-1-Proteinase Inhibitor | 13 | $113,772 |
| Breztri AerosphereBudesonide/Glycopyr/Formoterol | 100 | $73,567 |
| Anoro ElliptaUmeclidinium Brm/Vilanterol Tr | 49 | $26,756 |
| Spiriva RespimatTiotropium Bromide | 28 | $19,757 |
| Stiolto RespimatTiotropium Br/Olodaterol Hcl | 25 | $14,709 |
| SymbicortBudesonide/Formoterol Fumarate | 59 | $13,559 |
| Combivent RespimatIpratropium/Albuterol Sulfate | 24 | $12,959 |
| Spiriva HandihalerTiotropium Bromide | 19 | $10,683 |
| Breo ElliptaFluticasone/Vilanterol | 26 | $10,566 |
| Fluticasone-SalmeterolFluticasone Propion/Salmeterol | 44 | $5,674 |
| Incruse ElliptaUmeclidinium Bromide | 12 | $4,180 |
| Albuterol Sulfate HfaAlbuterol Sulfate | 158 | $3,773 |
| BreynaBudesonide/Formoterol Fumarate | 14 | $2,365 |
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 |
|---|---|---|
| Boehringer IngelheimOfev, Spiriva Respimat, Stiolto Respimat, Combivent Respimat | $620 | $403,437104 claims |
| GSKTrelegy Ellipta, Anoro Ellipta, Breo Ellipta, Incruse Ellipta | $709 | $172,216237 claims |
| AstraZenecaBreztri Aerosphere, Symbicort | $541 | $87,126159 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 33 sleep medicine providers in Missouri.
Other sleep medicine in Joplin
- Jason MaxfieldJoplin$2K
- Steven GradneySpringfield$926K
- Raman MalhotraSaint Louis$7K
- David IngramKansas City$7K
- Joseph Roland EspirituSt. Louis$7K
- Rutwik PatelSaint Louis$4K
- David KuhlmannSedalia$3K
- Oscar SchwartzSaint Louis$3K
- Beth WardChesterfield$2K
- Scott ShortenNorth Kansas City$2K
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.