Ian Smithson, MD
Hand Surgery · Lynchburg, VANPI 1891014247
Payments from drug & device makers
What this record shows
The money is spread across several categories — education (51.5%), travel and lodging and food and beverage — rather than concentrated in one kind of arrangement. Arthrex accounts for 79.7% of it on its own, with 3 other manufacturers making up the rest. Reporting peaked in 2019 at $3,126 and has fallen 56.1% since, to $1,374 in 2025.
Across 27 payments — averaging $177.23 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Arthrex$4K
- Fortis Surgical, LLC$773
- Endo Pharmaceuticals Inc.$125
- Encore Medical, LP$75
What the payments were for
- Travel & lodging$1,50631%
- Food & beverage$81417%
- Education$2,46652%
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 |
|---|---|---|
| Arthrex | 21 | $3,812 |
| Fortis Surgical, LLC | 4 | $773 |
| Endo Pharmaceuticals Inc. | 1 | $125 |
| Encore Medical, LP | 1 | $75 |
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.
- XIAFLEX$125
How this compares
$4,785 in reported general payments places this provider in the 60th percentile of 81 hand surgery providers in Virginia.
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 |
|---|---|---|
| Diclofenac Sodium | 151 | $2,488 |
| Celecoxib | 81 | $1,819 |
| Oxycodone-AcetaminophenOxycodone Hcl/Acetaminophen | 169 | $1,254 |
| Ciclopirox | 31 | $1,114 |
| Ondansetron OdtOndansetron | 129 | $802 |
| Gabapentin | 67 | $678 |
| Hydrocodone-AcetaminophenHydrocodone/Acetaminophen | 90 | $495 |
| Tranexamic Acid | 45 | $285 |
| Methylprednisolone | 35 | $226 |
| Meloxicam | 104 | $198 |
| Tramadol Hcl | 33 | $138 |
| Colchicine | 11 | $126 |
| Cyclobenzaprine Hcl | 29 | $101 |
| Oxycodone Hcl | 15 | $91 |
| Allopurinol | 19 | $81 |
Paid to pharmacies, not to this prescriber.
Other hand surgery in Lynchburg
- Drew KiernanLynchburg$15K
- Lance DavlinNorfolk$165K
- Chad MankeVa Beach$104K
- Frank GwathmeyNorfolk$68K
- Angelo DacusCharlottesville$57K
- Kacy PeekCharlottesville$31K
- Rikesh GandhiArlington$22K
- Nicole SgromoloFort Belvoir$17K
- Jeffrey LovalloArlington$16K
- Giacomo CappelletiNorfolk$15K
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.