Graciela Spencer
Physician Assistant · Seguin, TXNPI 1720011430
Payments from drug & device makers
Across 12 payments — averaging $87.05 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Caldera Medical, Inc$252
- Kerecis Limited$146
- Insightec,inc$133
- Biohaven Pharmaceuticals, Inc.$122
- Phathom Pharmaceuticals, Inc.$122
- AstraZeneca$100
- plus $169 from 3 others
What the payments were for
- Food & beverage$1,045100%
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 |
|---|---|---|
| Caldera Medical, Inc | 2 | $252 |
| Kerecis Limited | 1 | $146 |
| Insightec,inc | 2 | $133 |
| Biohaven Pharmaceuticals, Inc. | 2 | $122 |
| Phathom Pharmaceuticals, Inc. | 1 | $122 |
| AstraZeneca | 1 | $100 |
| Boston Scientific | 1 | $98 |
| Johnson & Johnson | 1 | $51 |
| Philips North America LLC | 1 | $20 |
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.
- Kerecis SurgiClose$583
- Kerecis GraftGuide$146
- VOQUEZNA$122
- FASENRA$100
How this compares
$1,045 in reported general payments places this provider in the 65th percentile of 8,308 physician assistant 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 |
|---|---|---|
| OzempicSemaglutide | 50 | $68,156 |
| JanuviaSitagliptin Phosphate | 27 | $48,570 |
| JardianceEmpagliflozin | 36 | $37,312 |
| TrulicityDulaglutide | 16 | $21,811 |
| MyrbetriqMirabegron | 12 | $17,358 |
| EliquisApixaban | 13 | $16,189 |
| LinzessLinaclotide | 15 | $9,434 |
| Humalog Kwikpen U-100Insulin Lispro | 16 | $5,974 |
| Lantus SolostarInsulin Glargine,hum.Rec.Anlog | 24 | $3,213 |
| Omeprazole | 110 | $3,141 |
| Albuterol Sulfate HfaAlbuterol Sulfate | 85 | $1,769 |
| Duloxetine Hcl | 51 | $1,518 |
| Atorvastatin Calcium | 210 | $1,308 |
| Fluticasone Propionate | 38 | $934 |
| Amlodipine Besylate | 125 | $805 |
Paid to pharmacies, not to this prescriber.
Other physician assistant in Seguin
- Cynthia TrickettDallas$1.3M
- Kristine KuceraMelissa$797K
- Selina SantosAustin$543K
- Matthew BrunoMcKinney$538K
- Anthony DerenciusSan Antonio$507K
- Brooke HodnickSouthlake$479K
- Holly GloverArlington$418K
- Kirk GautierAthens$416K
- Jaime RomanPlano$338K
- Michael WhiteDallas$276K
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.