James Randle, MD
Neurological Surgery · Nacogdoches, TXNPI 1457460370
Payments from drug & device makers
What this record shows
This record is dominated by royalties or licence payments: $209,141 of the $252,530 with a category attached, or 82.8%. The Institute Of Musculoskeletal Science And Education accounts for 82.8% of it on its own, with 5 other manufacturers making up the rest. Reporting peaked in 2023 at $68,365 and has fallen 88.0% since, to $8,206 in 2025. Among neurological surgery 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 45 payments — averaging $5611.77 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- The Institute Of Musculoskeletal Science And Education$209K
- CTL Medical Corporation$42K
- Wenzel Spine, Inc.$1K
- Globus Medical$30
- Johnson & Johnson$17
- Stryker$14
What the payments were for
- Royalty or licence$209,14183%
- Consulting fees$41,50016%
- Food & beverage$1,8891%
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 |
|---|---|---|
| The Institute Of Musculoskeletal Science And Education | 20 | $209,141 |
| CTL Medical Corporation | 17 | $41,853 |
| Wenzel Spine, Inc. | 5 | $1,475 |
| Globus Medical | 1 | $30 |
| Johnson & Johnson | 1 | $17 |
| Stryker | 1 | $14 |
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.
- Orthros$84,929
- Spira$82,833
- Spinal$33,500
- Raphael Pedicle Screw System$8,000
- Varilift$1,200
- VariLift-LX$275
How this compares
$252,530 in reported general payments places this provider in the 95th percentile of 582 neurological surgery 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 |
|---|---|---|
| Hydrocodone-AcetaminophenHydrocodone/Acetaminophen | 93 | $1,695 |
| Tizanidine Hcl | 83 | $596 |
| Acetaminophen-CodeineAcetaminophen With Codeine | 13 | $170 |
| Levetiracetam | 12 | $127 |
| Gabapentin | 13 | $102 |
| Tramadol Hcl | 17 | $54 |
| Alprazolam | 12 | $34 |
Paid to pharmacies, not to this prescriber.
Other neurological surgery in Nacogdoches
- Koijan KainthThe Woodlands$1.3M
- Luis DuarteSan Angelo$1.2M
- Douglas FoxAustin$948K
- Richard MeyratDallas$883K
- Adam LewisCorpus Christi$792K
- Arnold VardimanSan Antonio$687K
- Andrew RoeserHouston$660K
- Scott RobertsonRound Rock$606K
- Sabatino BiancoArlington$564K
- Rebecca StachniakPlano$561K
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.