Irl Extein, MD
Psychiatry · Delray Beach, FLNPI 1801962675
Payments from drug & device makers
Across 153 payments — averaging $21.02 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Teva Pharmaceuticals USA, Inc.$501
- Takeda Pharmaceuticals U.S.A., Inc.$474
- AbbVie$459
- Otsuka America Pharmaceutical, Inc.$443
- Lundbeck LLC$333
- ITI, Inc. (d/b/a Intra-cellular Therapies, Inc.)$249
- plus $758 from 10 others
What the payments were for
- Food & beverage$3,208100%
- Education$80%
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 |
|---|---|---|
| Teva Pharmaceuticals USA, Inc. | 16 | $501 |
| Takeda Pharmaceuticals U.S.A., Inc. | 27 | $474 |
| AbbVie(2 entities) | 34 | $459 |
| Otsuka America Pharmaceutical, Inc. | 17 | $443 |
| Lundbeck LLC | 17 | $333 |
| ITI, Inc. (d/b/a Intra-cellular Therapies, Inc.) | 7 | $249 |
| Avanir Pharmaceuticals, Inc. | 17 | $203 |
| E.r. Squibb & Sons, L.L.C. | 2 | $154 |
| Alkermes, Inc. | 6 | $124 |
| Johnson & Johnson | 2 | $117 |
| Almatica Pharma LLC | 2 | $38 |
| Shire North American Group Inc | 2 | $32 |
| Tempus AI, Inc | 1 | $27 |
| Vanda Pharmaceuticals Inc. | 1 | $24 |
| Livanova USA, Inc. | 1 | $22 |
| Alfasigma USA, Inc. | 1 | $17 |
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
$3,216 in reported general payments places this provider in the 75th percentile of 2,059 psychiatry providers in Florida.
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 |
|---|---|---|
| Austedo XrDeutetrabenazine | 22 | $132,081 |
| VraylarCariprazine Hcl | 45 | $80,824 |
| Abilify MaintenaAripiprazole | 19 | $53,125 |
| RexultiBrexpiprazole | 25 | $25,042 |
| TrintellixVortioxetine Hydrobromide | 33 | $23,277 |
| ExelonRivastigmine | 11 | $11,887 |
| Aripiprazole | 276 | $10,394 |
| VyvanseLisdexamfetamine Dimesylate | 27 | $7,964 |
| AdderallDextroamphetamine/Amphetamine | 12 | $7,589 |
| Mirtazapine | 378 | $7,117 |
| AuvelityDextromethorphan Hbr/Bupropion | 12 | $6,560 |
| Sertraline Hcl | 580 | $6,532 |
| Lurasidone Hcl | 13 | $5,729 |
| Clonazepam | 382 | $5,714 |
| Clozapine | 59 | $5,566 |
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 |
|---|---|---|
| Teva Pharmaceuticals USA, Inc.Austedo Xr | $501 | $132,08122 claims |
| AbbVieVraylar, Lexapro | $459 | $86,16958 claims |
| Otsuka America Pharmaceutical, Inc.Abilify Maintena, Rexulti | $443 | $78,16744 claims |
| Takeda Pharmaceuticals U.S.A., Inc.Trintellix, Vyvanse, Adderall | $474 | $38,82972 claims |
| Almatica Pharma LLCSertraline Hcl | $38 | $6,532580 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 75th percentile of 2,059 psychiatry providers in Florida.
Other psychiatry in Delray Beach
- Edwin GomezWeston$24.9M
- Rishi KakarTamarac$23.9M
- Peter VentreOakland Park$18.7M
- Jose GamezHialeah$14.8M
- John JoyceJacksonville$13.6M
- Silvia Silva-DulucMiami$11.7M
- Kelley WilsonTampa$11.1M
- Emilio Mantero-AtienzaMiami Beach$10.9M
- Patricia JunqueraMiami$10.8M
- Olga LapeyraLauderhill$10M
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.