James Francis, MD
Nephrology · Lexington, KYNPI 1508878349
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 90.6% of the total across 145 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 24 manufacturers, the largest accounting for just 18.7% — the pattern of someone who eats at a lot of different presentations. 2025 is the largest year on record at $1,026, 9.9 times the $104 reported in 2019.
Across 145 payments — averaging $20.09 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Fresenius USA Marketing, Inc.$544
- AstraZeneca$379
- Amgen$349
- Travere Therapeutics, Inc.$247
- Novartis$186
- Otsuka America Pharmaceutical, Inc.$152
- plus $1K from 18 others
What the payments were for
- Food & beverage$2,63991%
- Education$2749%
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 |
|---|---|---|
| Fresenius USA Marketing, Inc. | 32 | $544 |
| AstraZeneca(2 entities) | 17 | $379 |
| Amgen(2 entities) | 17 | $349 |
| Travere Therapeutics, Inc. | 9 | $247 |
| Novartis | 11 | $186 |
| Otsuka America Pharmaceutical, Inc. | 8 | $152 |
| Aurinia Pharma U.S., Inc. | 9 | $151 |
| OPKO Pharmaceuticals, LLC | 8 | $147 |
| Mallinckrodt Hospital Products Inc. | 7 | $147 |
| Bayer | 6 | $102 |
| Calliditas Therapeutics US Inc. | 5 | $94 |
| Nxstage Medical, Inc. | 1 | $72 |
| Novo Nordisk | 3 | $62 |
| Lilly USA, LLC | 2 | $54 |
| Inari Medical, Inc. | 1 | $40 |
| Ultragenyx Pharmaceutical Inc. | 1 | $30 |
| Applied Medical Resources Corporation | 1 | $29 |
| GSK | 1 | $26 |
| Ardelyx, Inc. | 1 | $22 |
| Vifor Pharma, Inc. | 1 | $21 |
| Boston Scientific | 1 | $16 |
| Boehringer Ingelheim | 1 | $15 |
| Bard Peripheral Vascular, Inc. | 1 | $15 |
| Xeris Pharmaceuticals, Inc. | 1 | $12 |
How this compares
$2,913 in reported general payments places this provider in the 65th percentile of 165 nephrology providers in Kentucky.
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 |
|---|---|---|
| VelphoroSucroferric Oxyhydroxide | 71 | $323,161 |
| KerendiaFinerenone | 21 | $19,406 |
| FarxigaDapagliflozin Propanediol | 25 | $19,331 |
| JardianceEmpagliflozin | 15 | $14,591 |
| Sevelamer Carbonate | 43 | $4,567 |
| Bumetanide | 107 | $3,373 |
| Nifedipine ErNifedipine | 54 | $1,506 |
| Calcium Acetate | 35 | $1,210 |
| Doxazosin Mesylate | 69 | $819 |
| Losartan Potassium | 93 | $811 |
| Calcitriol | 36 | $788 |
| Carvedilol | 108 | $709 |
| Diltiazem 24hr Er (Cd)Diltiazem Hcl | 12 | $490 |
| Lisinopril | 86 | $458 |
| Hydralazine Hcl | 33 | $322 |
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 |
|---|---|---|
| Fresenius USA Marketing, Inc.Velphoro | $544 | $323,16171 claims |
| BayerKerendia | $102 | $19,40621 claims |
| AstraZenecaFarxiga | $379 | $19,33125 claims |
| Boehringer IngelheimJardiance | $15 | $14,59115 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 65th percentile of 165 nephrology providers in Kentucky.
Other nephrology in Lexington
- Javier Neyra LozanoLexington$181K
- Sadiq AhmedLexington$17K
- Madhumathi RaoLexington$11K
- Hartmut MallucheLexington$10K
- Amr MohamedLexington$9K
- Thomas FergusonLexington$6K
- Adam DossajiLexington$6K
- Juan Carlos AycinenaLexington$6K
- Khalil RahmanLexington$5K
- Faizan BabarLexington$5K
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.