Jakob Fischer, MD
Otolaryngology · Jbsa Ft Sam Houston, TXNPI 1982137550
Payments from drug & device makers
What this record shows
This record is dominated by grants: $20,000 of the $24,118 with a category attached, or 82.9%. Medtronic accounts for 87.5% of it on its own, with 8 other manufacturers making up the rest. 2025 is the largest year on record at $21,919, more than ten times the $134 reported in 2022. Among otolaryngology clinicians in TX with any reported payments, this total sits in the top 5% — high for the specialty, which is a reason to read the composition above rather than the number alone.
Across 37 payments — averaging $651.85 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Medtronic$21K
- Aerin Medical Inc.$1K
- Stryker$470
- AbbVie$300
- Integra Lifesciences Corporation$293
- AstraZeneca$210
- plus $404 from 3 others
What the payments were for
- Grants$20,00083%
- Food & beverage$4,11817%
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 |
|---|---|---|
| Medtronic | 10 | $21,102 |
| Aerin Medical Inc. | 11 | $1,340 |
| Stryker | 5 | $470 |
| AbbVie | 2 | $300 |
| Integra Lifesciences Corporation | 3 | $293 |
| AstraZeneca | 2 | $210 |
| Smith+Nephew | 1 | $148 |
| Sanofi | 1 | $133 |
| GSK | 2 | $123 |
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.
- STRAIGHTSHOT$20,000
- VIVAER STYLUS$1,149
- RHINAER STYLUS$1,149
- STEALTHSTATION S8 PLATFORM$588
- INTEGRA$472
- PROPEL$409
- BOTOX$300
- DUPIXENT$267
- NA$160
- INTEGRA DERMAL REGENERATION TEMPLATE$157
- PRIMATRIX$157
- SCOPIS ENT$141
- AUDION ET DILATION SYSTEM$124
How this compares
$24,118 in reported general payments places this provider in the 95th percentile of 729 otolaryngology 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 |
|---|---|---|
| Ipratropium Bromide | 26 | $832 |
| Amoxicillin-Clavulanate PotassAmoxicillin/Potassium Clav | 17 | $304 |
| Famotidine | 12 | $185 |
| Fluticasone Propionate | 21 | $121 |
Paid to pharmacies, not to this prescriber.
Other otolaryngology in Jbsa Ft Sam Houston
- Marc DeanFort Worth$486K
- Amber LuongHouston$426K
- Arjuna KuperanHouston$348K
- Ronald KuppersmithCollege Station$325K
- Ron KarniHouston$317K
- Philip ChenSan Antonio$305K
- Jordan RihaniSouthlake$280K
- Keith MathenyFrisco$269K
- Martin CitardiHouston$245K
- James AtkinsSan Antonio$205K
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.