James Cain, MD
Nephrology · Roanoke, VANPI 1770581761
Payments from drug & device makers
What this record shows
This record is dominated by speaking fees: $7,200 of the $8,798 with a category attached, or 81.8%. Vifor Pharma, Inc. accounts for 94.9% of it on its own, with 8 other manufacturers making up the rest. Reporting peaked in 2019 at $8,301 and has fallen 99.3% since, to $56 in 2025. Among nephrology clinicians in VA with any reported payments, this total sits in the top 10% — high for the specialty, which is a reason to read the composition above rather than the number alone.
Across 55 payments — averaging $159.97 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Vifor Pharma, Inc.$8K
- GSK$118
- Otsuka America Pharmaceutical, Inc.$103
- Amgen$85
- Boston Scientific$56
- Mallinckrodt Enterprises LLC$30
- plus $53 from 3 others
Across 4 payments — averaging $30,896 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.
- AstraZeneca$113K
- Astrazeneca UK Limited$10K
What the payments were for
- Speaking & faculty fees$7,20082%
- Travel & lodging$5857%
- Food & beverage$99411%
- Education$190%
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 |
|---|---|---|
| Vifor Pharma, Inc. | 39 | $8,353 |
| GSK | 1 | $118 |
| Otsuka America Pharmaceutical, Inc. | 3 | $103 |
| Amgen | 4 | $85 |
| Boston Scientific | 2 | $56 |
| Mallinckrodt Enterprises LLC | 2 | $30 |
| AstraZeneca | 2 | $23 |
| Daiichi Sankyo Inc. | 1 | $17 |
| Akebia Therapeutics Inc | 1 | $13 |
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
$8,798 in reported general payments places this provider in the 90th percentile of 298 nephrology providers in Virginia.
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 |
|---|---|---|
| FarxigaDapagliflozin Propanediol | 58 | $71,702 |
| AuryxiaFerric Citrate | 14 | $55,297 |
| VelphoroSucroferric Oxyhydroxide | 12 | $20,748 |
| Sevelamer Carbonate | 36 | $6,769 |
| Furosemide | 131 | $706 |
| Famotidine | 40 | $703 |
| Midodrine Hcl | 15 | $685 |
| Losartan Potassium | 32 | $355 |
| Calcitriol | 11 | $293 |
| Amlodipine Besylate | 30 | $188 |
| Metolazone | 21 | $179 |
| Carvedilol | 13 | $124 |
| Minoxidil | 12 | $88 |
| Hydrochlorothiazide | 22 | $50 |
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 |
|---|---|---|
| AstraZenecaFarxiga | $23 | $71,70258 claims |
| Akebia Therapeutics IncAuryxia | $13 | $55,29714 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 90th percentile of 298 nephrology providers in Virginia.
Other nephrology in Roanoke
- Ryan EvansRoanoke$7K
- Matt MathewRoanoke$5K
- Saowanee PowellRoanoke$5K
- Shahram AhmadzadehRoanoke$4K
- Abdelaziz ElsanjakRoanoke$4K
- Ramon MendezWoodbridge$791K
- Reza ZonoziFairfax$262K
- Sandeep MagoonNorfolk$204K
- Thomas McCuneNorfolk$202K
- Gaurav GuptaRichmond$168K
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.