Gary Koenig, MD
Allergy & Immunology · Omaha, NENPI 1942204656
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 95.8% of the total across 264 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 35 manufacturers, the largest accounting for just 18.0% — the pattern of someone who eats at a lot of different presentations. Reporting peaked in 2023 at $1,130 and has fallen 57.1% since, to $485 in 2025. That places this record below the midpoint for allergy & immunology clinicians in NE, where the typical reported total is $7,833.
Across 264 payments — averaging $16.59 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Harmony Biosciences LLC$790
- Boehringer Ingelheim$433
- AstraZeneca$355
- Grifols USA, LLC$321
- Jazz Pharmaceuticals Inc.$219
- Amgen$204
- plus $2K from 29 others
What the payments were for
- Food & beverage$4,19496%
- Education$1854%
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 |
|---|---|---|
| Harmony Biosciences LLC | 47 | $790 |
| Boehringer Ingelheim | 25 | $433 |
| AstraZeneca | 19 | $355 |
| Grifols USA, LLC | 18 | $321 |
| Jazz Pharmaceuticals Inc. | 14 | $219 |
| Amgen | 11 | $204 |
| United Therapeutics Corporation | 10 | $185 |
| Actelion Pharmaceuticals US, Inc. | 12 | $183 |
| Genentech USA, Inc. | 23 | $167 |
| GSK | 12 | $158 |
| Takeda Pharmaceuticals U.S.A., Inc. | 7 | $133 |
| Itamar Medical Inc | 2 | $115 |
| Sanofi | 7 | $114 |
| Bayer | 5 | $101 |
| Philips North America LLC | 5 | $95 |
| Avadel CNS Pharmaceuticals, LLC | 6 | $95 |
| Insmed, Inc. | 5 | $87 |
| Pulmonx Corporation | 2 | $85 |
| CSL Behring | 3 | $85 |
| Regeneron Healthcare Solutions, Inc. | 5 | $72 |
| Axsome Therapeutics, Inc. | 4 | $56 |
| Mylan Specialty L.p. | 3 | $49 |
| Sunovion Pharmaceuticals Inc. | 5 | $40 |
| Mallinckrodt Hospital Products Inc. | 1 | $33 |
| Azurity Pharmaceuticals, Inc. | 2 | $30 |
| Gilead | 1 | $23 |
| Pharming Healthcare, Inc. | 1 | $21 |
| Merck | 1 | $18 |
| Lilly USA, LLC | 1 | $18 |
| ZOLL Respicardia, Inc. | 1 | $17 |
| Baxter Healthcare | 1 | $16 |
| Electromed, Inc. | 2 | $16 |
| Applied Medical Technology Inc | 1 | $14 |
| Vifor Pharma, Inc. | 1 | $14 |
| Novartis | 1 | $14 |
How this compares
$4,379 in reported general payments places this provider in the 40th percentile of 21 allergy & immunology providers in Nebraska.
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 | 34 | $382,449 |
| Trelegy ElliptaFluticasone/Umeclidin/Vilanter | 499 | $380,105 |
| UptraviSelexipag | 13 | $302,608 |
| GlassiaAlpha-1-Proteinase Inhibitor | 14 | $144,914 |
| Breo ElliptaFluticasone/Vilanterol | 67 | $37,065 |
| Spiriva HandihalerTiotropium Bromide | 32 | $24,442 |
| SymbicortBudesonide/Formoterol Fumarate | 63 | $22,169 |
| Anoro ElliptaUmeclidinium Brm/Vilanterol Tr | 43 | $19,450 |
| Incruse ElliptaUmeclidinium Bromide | 34 | $17,530 |
| Ambrisentan | 20 | $16,577 |
| Combivent RespimatIpratropium/Albuterol Sulfate | 13 | $12,515 |
| Azelastine Hcl | 393 | $9,421 |
| Fluticasone-SalmeterolFluticasone Propion/Salmeterol | 77 | $7,782 |
| Budesonide-Formoterol FumarateBudesonide/Formoterol Fumarate | 28 | $5,437 |
| Fluticasone Propionate | 328 | $5,216 |
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 |
|---|---|---|
| GSKTrelegy Ellipta, Breo Ellipta, Anoro Ellipta, Incruse Ellipta, Arnuity Ellipta | $158 | $457,435657 claims |
| Boehringer IngelheimOfev, Combivent Respimat | $433 | $394,96447 claims |
| Actelion Pharmaceuticals US, Inc.Uptravi | $183 | $302,60813 claims |
| Takeda Pharmaceuticals U.S.A., Inc.Glassia | $133 | $144,91414 claims |
| AstraZenecaSymbicort | $355 | $22,16963 claims |
| MerckDulera | $18 | $4,09112 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 40th percentile of 21 allergy & immunology providers in Nebraska.
Other allergy & immunology in Omaha
- James TracyOmaha$104K
- Roger KobayashiOmaha$45K
- Mitchell PitlickOmaha$26K
- James FriedlanderOmaha$22K
- Brett KettelhutOmaha$21K
- Teodoro SeguraOmaha$8K
- Sara MayOmaha$2K
- Brian KellyOmaha$1K
- Jose Zamora SifuentesOmaha$786
- Joel van de GraaffOmaha$692
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.