Gerard Meskill, MD
Sleep Medicine · Sugar Land, TXNPI 1295975324
Payments from drug & device makers
What this record shows
This record is dominated by speaking fees: $727,687 of the $1,047,210 with a category attached, or 69.5%. 19 manufacturers reported payments, led by Jazz Pharmaceuticals Inc. at 48.1% of the total. 2025 is the largest year on record at $241,754, 2.6 times the $93,102 reported in 2019. Among sleep medicine clinicians in TX with any reported payments, this total sits in the top 5% — high for the specialty, which is a reason to read the composition above rather than the number alone.
Across 1,359 payments — averaging $770.57 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Jazz Pharmaceuticals Inc.$503K
- Harmony Biosciences LLC$156K
- Axsome Therapeutics, Inc.$149K
- Avadel CNS Pharmaceuticals, LLC$130K
- Lilly USA, LLC$93K
- Idorsia Pharmaceuticals US Inc$16K
- plus $639 from 13 others
Across 435 payments — averaging $1825.79 each. Payments tied to a research study. These frequently flow through the physician to a hospital or research institution rather than to the physician personally.
- Alkermes, Inc.$716K
- Jazz Pharmaceuticals Inc.$78K
What the payments were for
- Consulting fees$188,77418%
- Speaking & faculty fees$727,68769%
- Travel & lodging$105,16210%
- Food & beverage$24,7702%
- Education$8170%
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 |
|---|---|---|
| Jazz Pharmaceuticals Inc. | 631 | $503,464 |
| Harmony Biosciences LLC | 250 | $156,368 |
| Axsome Therapeutics, Inc. | 165 | $148,747 |
| Avadel CNS Pharmaceuticals, LLC | 160 | $129,766 |
| Lilly USA, LLC | 104 | $92,556 |
| Idorsia Pharmaceuticals US Inc | 26 | $15,672 |
| Inspire Medical Systems, Inc. | 4 | $286 |
| AbbVie | 3 | $73 |
| Arbor Pharmaceuticals, Inc. | 5 | $67 |
| Amgen | 2 | $34 |
| Resmed Corp | 1 | $27 |
| Biohaven Pharmaceutical Holding Company Ltd. | 1 | $23 |
| Biohaven Pharmaceuticals, Inc. | 1 | $23 |
| ZOLL Respicardia, Inc. | 1 | $23 |
| Azurity Pharmaceuticals, Inc. | 1 | $20 |
| Livanova USA, Inc. | 1 | $18 |
| Merck | 1 | $17 |
| Pfizer | 1 | $14 |
| Novartis | 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
$1,047,210 in reported general payments places this provider in the 95th percentile of 112 sleep medicine 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 |
|---|---|---|
| XywavSodium,calcium,mag,pot Oxybate | 67 | $855,450 |
| WakixPitolisant Hcl | 11 | $147,530 |
| SunosiSolriamfetol Hcl | 25 | $25,880 |
| BelsomraSuvorexant | 20 | $10,086 |
| QuviviqDaridorexant Hcl | 12 | $5,953 |
| Zolpidem Tartrate | 83 | $2,344 |
| Armodafinil | 43 | $2,226 |
| Dextroamphetamine-Amphet ErDextroamphetamine/Amphetamine | 11 | $1,951 |
| Zaleplon | 71 | $1,685 |
| Dextroamphetamine-AmphetamineDextroamphetamine/Amphetamine | 16 | $650 |
| Eszopiclone | 13 | $503 |
| Modafinil | 11 | $390 |
| Pramipexole DihydrochloridePramipexole Di-Hcl | 17 | $266 |
| Temazepam | 12 | $228 |
| Methylphenidate Hcl | 15 | $204 |
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 |
|---|---|---|
| Harmony Biosciences LLCWakix | $156,368 | $147,53011 claims |
| Axsome Therapeutics, Inc.Sunosi | $148,747 | $25,88025 claims |
| MerckBelsomra | $17 | $10,08620 claims |
| Idorsia Pharmaceuticals US IncQuviviq | $15,672 | $5,95312 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 95th percentile of 112 sleep medicine providers in Texas.
Other sleep medicine in Sugar Land
- Vikas JainFrisco$673K
- Amit VermaHouston$493K
- Jerald SimmonsHouston$165K
- James AndrySan Antonio$100K
- William BurkesBeaumont$99K
- Ashwin GowdaAustin$71K
- John DebusDallas$38K
- Peter ObessoTyler$34K
- Karen Hentschel FranksSan Antonio$18K
- Bhavim DesaiAustin$17K
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.