Isobel Santos, MD
Surgery of the Hand · Fresno, CANPI 1316306574
Payments from drug & device makers
What this record shows
The money is spread across several categories — travel and lodging (45.7%), education and food and beverage — rather than concentrated in one kind of arrangement. 9 manufacturers reported payments, led by Arthrex at 35.5% of the total. Reporting peaked in 2022 at $1,971 and has fallen 94.2% since, to $115 in 2025.
Across 27 payments — averaging $143.39 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Arthrex$1K
- Pinnacle, Inc$1K
- Acumed LLC$557
- Endo Pharmaceuticals Inc.$189
- Axogen$171
- Sonex Health, Inc.$158
- plus $199 from 3 others
What the payments were for
- Travel & lodging$1,77146%
- Food & beverage$90123%
- Education$1,20031%
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 | 14 | $1,373 |
| Pinnacle, Inc | 2 | $1,225 |
| Acumed LLC | 1 | $557 |
| Endo Pharmaceuticals Inc. | 3 | $189 |
| Axogen | 3 | $171 |
| Sonex Health, Inc. | 1 | $158 |
| Davol Inc. | 1 | $139 |
| Zimmer Biomet | 1 | $40 |
| BD | 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.
- ACUMED$1,672
- OsteoMed$1,114
- XIAFLEX$161
- Sx-One Microknife$158
How this compares
$3,871 in reported general payments places this provider in the 65th percentile of 76 surgery of the hand providers in California.
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 |
|---|---|---|
| Tramadol Hcl | 11 | $17 |
Paid to pharmacies, not to this prescriber.
Other surgery of the hand in Fresno
- Ryan StehrFresno$3K
- Hongshik HanFresno$2K
- Ricardo AvenaFresno$451
- Alexander MajorsFresno$426
- Randi GalliFresno$426
- Bauback SafaSan Francisco$172K
- Emily Perezla Mirada$56K
- Joshua GluckVentura$26K
- Howard SutkinLos Gatos$22K
- Aaron BergerOakland$14K
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.