Fred Speck, MD
Dermatology · Kerrville, TXNPI 1639104466
Payments from drug & device makers
Across 10 payments — averaging $50.32 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Stryker$168
- Amgen$125
- Eli Lilly$99
- Lundbeck LLC$31
- Organon$19
- Amneal Pharmaceuticals LLC$17
- plus $44 from 3 others
What the payments were for
- Food & beverage$40480%
- Education$9920%
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 |
|---|---|---|
| Stryker | 1 | $168 |
| Amgen | 1 | $125 |
| Eli Lilly | 1 | $99 |
| Lundbeck LLC | 1 | $31 |
| Organon | 2 | $19 |
| Amneal Pharmaceuticals LLC | 1 | $17 |
| Melinta Therapeutics, LLC | 1 | $15 |
| Dermavant Sciences, Inc. | 1 | $15 |
| Kerecis Limited | 1 | $13 |
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
$503 in reported general payments places this provider in the 15th percentile of 1,098 dermatology providers in Texas.
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 |
|---|---|---|
| Fluorouracil | 43 | $3,643 |
| Triamcinolone Acetonide | 272 | $3,290 |
| Minocycline Hcl | 117 | $3,085 |
| Fluticasone Propionate | 111 | $2,523 |
| Metronidazole | 50 | $2,230 |
| Doxycycline Hyclate | 66 | $1,432 |
| Azelaic Acid | 11 | $1,326 |
| Clobetasol Propionate | 46 | $1,210 |
| Betamethasone Dipropionate | 25 | $1,105 |
| Terbinafine Hcl | 39 | $617 |
| Desonide | 14 | $600 |
| Fluocinonide | 23 | $470 |
| Cephalexin | 43 | $335 |
| ValacyclovirValacyclovir Hcl | 21 | $315 |
| Nystatin | 19 | $211 |
Paid to pharmacies, not to this prescriber.
Other dermatology in Kerrville
- Stephen TyringWebster$14.1M
- Edward LainAustin$12M
- Mark LeeSan Antonio$10.9M
- John BrowningSan Antonio$10.7M
- Craig TellerBellaire$7.7M
- Patricia LeeWebster$7.2M
- Jennifer CatherDallas$4.9M
- Michael MigdenHouston$3.7M
- Martin MenterDallas$3.7M
- Janet DuboisAustin$3.5M
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.