James Bruton, MD
Nephrology · Fort Smith, ARNPI 1245228055
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 99.3% of the total across 240 separate payments, which is the pattern of a clinician who attends manufacturer presentations rather than one with a consulting arrangement. It is spread thinly across 30 manufacturers, the largest accounting for just 17.2% — the pattern of someone who eats at a lot of different presentations. 2025 is the largest year on record at $1,339, 2.2 times the $621 reported in 2019.
Across 240 payments — averaging $20.60 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Amgen$852
- AstraZeneca$632
- Novartis$357
- Novo Nordisk$341
- GSK$333
- OPKO Pharmaceuticals, LLC$321
- plus $2K from 24 others
What the payments were for
- Food & beverage$4,90999%
- Education$341%
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 |
|---|---|---|
| Amgen(2 entities) | 41 | $852 |
| AstraZeneca(2 entities) | 37 | $632 |
| Novartis | 14 | $357 |
| Novo Nordisk | 16 | $341 |
| GSK | 13 | $333 |
| OPKO Pharmaceuticals, LLC | 18 | $321 |
| Travere Therapeutics, Inc. | 15 | $288 |
| Ardelyx, Inc. | 8 | $214 |
| Aurinia Pharma U.S., Inc. | 7 | $200 |
| Fresenius USA Marketing, Inc. | 8 | $172 |
| Vifor Pharma, Inc. | 8 | $158 |
| Bayer | 8 | $153 |
| Boehringer Ingelheim | 9 | $134 |
| Calliditas Therapeutics US Inc. | 5 | $123 |
| Akebia Therapeutics Inc | 6 | $116 |
| ANI Pharmaceuticals, Inc. | 4 | $104 |
| Otsuka America Pharmaceutical, Inc. | 4 | $82 |
| Johnson & Johnson | 3 | $66 |
| Mallinckrodt Enterprises LLC | 3 | $47 |
| Ultragenyx Pharmaceutical Inc. | 2 | $46 |
| Cormedix Inc. | 2 | $35 |
| Vantive US Healthcare LLC | 1 | $24 |
| AbbVie | 1 | $22 |
| Bard Peripheral Vascular, Inc. | 1 | $21 |
| Takeda Pharmaceuticals U.S.A., Inc. | 1 | $20 |
| Otsuka Pharmaceutical Development & Commercialization, Inc. | 1 | $18 |
| Daiichi Sankyo Inc. | 1 | $18 |
| Ascendis Pharma Endocrinology Inc | 1 | $17 |
| Nxstage Medical, Inc. | 1 | $16 |
| Scpharmaceuticals Inc. | 1 | $15 |
How this compares
$4,943 in reported general payments places this provider in the 80th percentile of 85 nephrology 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 |
|---|---|---|
| Humira(Cf) PenAdalimumab | 12 | $96,313 |
| RenvelaSevelamer Carbonate | 15 | $23,003 |
| JardianceEmpagliflozin | 23 | $21,017 |
| Sevelamer Carbonate | 66 | $8,380 |
| EliquisApixaban | 11 | $6,907 |
| Calcium Acetate | 92 | $5,166 |
| Tolvaptan | 12 | $4,469 |
| SpsSodium Polystyrene Sulfon/Sorb | 11 | $1,966 |
| Potassium Chloride | 91 | $1,612 |
| Labetalol Hcl | 69 | $1,273 |
| Hydrocodone-AcetaminophenHydrocodone/Acetaminophen | 51 | $1,240 |
| Hydralazine Hcl | 78 | $925 |
| Torsemide | 45 | $914 |
| Humulin 70-30Insulin Nph Hum/Reg Insulin Hm | 12 | $857 |
| Nifedipine ErNifedipine | 40 | $820 |
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 |
|---|---|---|
| Boehringer IngelheimJardiance | $134 | $21,01723 claims |
| Otsuka Pharmaceutical Development & Commercialization, Inc.Tolvaptan | $18 | $4,46912 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 80th percentile of 85 nephrology providers in Arkansas.
Other nephrology in Fort Smith
- Hania Al-ShahrouriFort Smith$8K
- Charles MoussallemFort Smith$5K
- James HenryFort Smith$5K
- Muhammad Zatmar KhanFort Smith$2K
- Divine RibakareFort Smith$2K
- Alex Eduardo Calderon RodriguezFort Smith$1K
- Andres Pirela AraqueFort Smith$558
- Dumitru RotaruFort Smith$553
- Drew HeipleRussellville$236K
- Luis JuncosLittle Rock$66K
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.