Jefrey Start, DO
Sleep Medicine · North Platte, NENPI 1093811036
Payments from drug & device makers
What this record shows
This record is dominated by food and beverage: $962 of the $1,356 with a category attached, or 70.9%. 6 manufacturers reported payments, led by Harmony Biosciences LLC at 42.8% of the total.
Across 35 payments — averaging $38.75 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Harmony Biosciences LLC$581
- Jazz Pharmaceuticals Inc.$343
- Itamar Medical Inc$256
- Axsome Therapeutics, Inc.$103
- Resmed Corp$58
- Inspire Medical Systems, Inc.$16
Across 37 payments — averaging $3216.70 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.
- Harmony Biosciences LLC$119K
What the payments were for
- Food & beverage$96271%
- Education$39429%
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 |
|---|---|---|
| Harmony Biosciences LLC | 15 | $581 |
| Jazz Pharmaceuticals Inc. | 9 | $343 |
| Itamar Medical Inc | 2 | $256 |
| Axsome Therapeutics, Inc. | 5 | $103 |
| Resmed Corp | 3 | $58 |
| Inspire Medical Systems, Inc. | 1 | $16 |
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.
- WatchPATONE$256
- XYWAV$116
- SUNOSI$116
How this compares
Too few sleep medicine providers in Nebraskato place this figure against a meaningful peer group, so we don't.
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 |
|---|---|---|
| Modafinil | 26 | $5,051 |
| Gabapentin | 11 | $18 |
Paid to pharmacies, not to this prescriber.
Other sleep medicine in North Platte
- Naresh DewanOmaha$5K
- Ankur SainiOmaha$3K
- John HarringtonOmaha$3K
- Stephanie WongOmaha$3K
- Minky SainiOmaha$2K
- Matthew DennisOmaha$584
- Michael SummersOmaha$237
- Mark WilsonOmaha$119
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.