Issam Makhoul, MD
Hematology & Oncology · Little Rock, ARNPI 1477643955
Payments from drug & device makers
What this record shows
The money is spread across several categories — travel and lodging (56.4%), food and beverage and education — rather than concentrated in one kind of arrangement. Reflexion Medical, Inc. accounts for 73.5% of it on its own, with 9 other manufacturers making up the rest. Reporting peaked in 2022 at $883 and has fallen 91.4% since, to $76 in 2024. That places this record below the midpoint for hematology & oncology clinicians in AR, where the typical reported total is $4,667.
Across 20 payments — averaging $57.65 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Reflexion Medical, Inc.$847
- CSL Behring$82
- Pfizer$48
- AstraZeneca$41
- Merck$40
- Sumitomo Pharma America, Inc.$34
- plus $61 from 4 others
Across 177 payments — averaging $19,393 each. Payments tied to a research study. These frequently flow through the physician to a hospital or research institution rather than to the physician personally.
- Pfizer$1.4M
- Merck$1.3M
- AstraZeneca$286K
- E.r. Squibb & Sons, L.L.C.$165K
- Seagen Inc.$137K
- Novartis$57K
- plus $27K from 2 others
What the payments were for
- Travel & lodging$65056%
- Food & beverage$40635%
- Education$978%
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 |
|---|---|---|
| Reflexion Medical, Inc. | 4 | $847 |
| CSL Behring | 4 | $82 |
| Pfizer | 3 | $48 |
| AstraZeneca | 2 | $41 |
| Merck | 2 | $40 |
| Sumitomo Pharma America, Inc. | 1 | $34 |
| Takeda Pharmaceuticals U.S.A., Inc. | 1 | $28 |
| United Therapeutics Corporation | 1 | $15 |
| Gilead | 1 | $12 |
| Veran Medical Technologies, Inc. | 1 | $6 |
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
$1,153 in reported general payments places this provider in the 30th percentile of 92 hematology & oncology providers in Arkansas.
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 |
|---|---|---|
| IbrancePalbociclib | 41 | $660,210 |
| Neulasta OnproPegfilgrastim | 60 | $416,851 |
| Everolimus | 35 | $343,697 |
| ImbruvicaIbrutinib | 12 | $140,846 |
| OntruzantTrastuzumab-Dttb | 17 | $84,181 |
| MvasiBevacizumab-Awwb | 14 | $58,913 |
| Fulvestrant | 78 | $57,256 |
| XgevaDenosumab | 14 | $42,359 |
| TrazimeraTrastuzumab-Qyyp | 12 | $40,905 |
| CreonLipase/Protease/Amylase | 30 | $30,345 |
| ZarxioFilgrastim-Sndz | 15 | $14,761 |
| EliquisApixaban | 16 | $9,312 |
| NivestymFilgrastim-Aafi | 12 | $7,754 |
| Anastrozole | 127 | $1,891 |
| Gabapentin | 88 | $1,403 |
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 |
|---|---|---|
| PfizerIbrance, Trazimera, Eliquis, Nivestym | $48 | $718,18381 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 30th percentile of 92 hematology & oncology providers in Arkansas.
Other hematology & oncology in Little Rock
- Frits van RheeLittle Rock$218K
- Appalanaidu SasapuLittle Rock$63K
- Peter EmanuelLittle Rock$53K
- Brad BaltzLittle Rock$25K
- Carolina SchinkeLittle Rock$23K
- Pooja MotwaniLittle Rock$21K
- Naveen YarlagaddaLittle Rock$18K
- Joseph BeckLittle Rock$16K
- Konstantinos ArnaoutakisLittle Rock$12K
- Abhijit GodboleLittle Rock$11K
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.