Heather Flugel
Nurse Practitioner · San Antonio, TXNPI 1912471178
Payments from drug & device makers
Across 143 payments — averaging $49.90 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Boston Scientific$2K
- Medtronic$2K
- Relievant Medsystems, Inc.$1K
- Globus Medical$820
- Averitas Pharma Inc.$288
- Nevro Corp.$188
- plus $938 from 15 others
What the payments were for
- Travel & lodging$3,00442%
- Food & beverage$4,12258%
- Education$90%
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 |
|---|---|---|
| Boston Scientific | 46 | $2,073 |
| Medtronic | 23 | $1,788 |
| Relievant Medsystems, Inc. | 13 | $1,041 |
| Globus Medical | 14 | $820 |
| Averitas Pharma Inc. | 5 | $288 |
| Nevro Corp. | 3 | $188 |
| Si-bone, Inc. | 4 | $173 |
| Collegium Pharmaceutical, Inc. | 8 | $136 |
| Biotronik NRO, Inc. | 4 | $123 |
| SPR Therapeutics, Inc | 3 | $82 |
| AbbVie | 3 | $77 |
| Spinal Simplicity, LLC | 3 | $66 |
| Avanos Medical | 3 | $56 |
| Scilex Pharmaceuticals Inc. | 3 | $44 |
| Saluda Medical Americas, Inc. | 1 | $39 |
| Pacira Pharmaceuticals Incorporated | 1 | $36 |
| Orthofix Medical, Inc. | 2 | $30 |
| IBSA Pharma Inc. | 1 | $22 |
| Livanova USA, Inc. | 1 | $20 |
| Fidia Pharma USA Inc. | 1 | $19 |
| Novo Nordisk | 1 | $14 |
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
$7,135 in reported general payments places this provider in the 95th percentile of 5,422 nurse practitioner 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 |
|---|---|---|
| BelbucaBuprenorphine Hcl | 53 | $43,966 |
| Buprenorphine | 37 | $8,526 |
| Tramadol Hcl ErTramadol Hcl | 79 | $6,228 |
| Acetaminophen-CodeineAcetaminophen With Codeine | 207 | $3,140 |
| Gabapentin | 270 | $3,136 |
| Pregabalin | 116 | $2,376 |
| Celecoxib | 49 | $1,687 |
| Tramadol Hcl | 248 | $1,258 |
| Orphenadrine Citrate ErOrphenadrine Citrate | 19 | $674 |
| Baclofen | 39 | $558 |
| Duloxetine Hcl | 32 | $506 |
| Tizanidine Hcl | 43 | $315 |
| Cyclobenzaprine Hcl | 70 | $308 |
| Methocarbamol | 36 | $225 |
| Methylprednisolone | 23 | $153 |
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 |
|---|---|---|
| Collegium Pharmaceutical, Inc.Belbuca | $136 | $43,96653 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 5,422 nurse practitioner providers in Texas.
Other nurse practitioner in San Antonio
- Corrie BerkSan Antonio$155K
- Sonja BruneSan Antonio$51K
- Laura GalvanSan Antonio$32K
- Eduardo GonzalezSan Antonio$32K
- Roberta RomeroSan Antonio$26K
- Christopher GarciaSan Antonio$21K
- Jennifer ZavalaSan Antonio$17K
- Amy RivasSan Antonio$17K
- Erika SimpsonSan Antonio$16K
- Alexis WahlenSan Antonio$16K
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.