John Vanaalst, MD
Plastic and Reconstructive Surgery · Louisville, KYNPI 1417043852
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 98.0% of the total across 2 separate payments, which is the pattern of a clinician who attends manufacturer presentations rather than one with a consulting arrangement. Every reported general payment came from a single manufacturer, Smith+Nephew. That places this record below the midpoint for plastic and reconstructive surgery clinicians in KY, where the typical reported total is $2,246.
Across 2 payments — averaging $58.99 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Smith+Nephew$118
What the payments were for
- Travel & lodging$22%
- Food & beverage$11698%
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.
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 |
|---|---|---|
| Smith+Nephew | 2 | $118 |
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.
- Santyl$116
How this compares
$118 in reported general payments places this provider in the 10th percentile of 43 plastic and reconstructive surgery providers in Kentucky.
See all plastic and reconstructive surgery 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 |
|---|---|---|
| TrulicityDulaglutide | 23 | $11,406 |
| SantylCollagenase Clostridium Hist. | 25 | $9,028 |
| Metronidazole | 32 | $2,408 |
| Clobetasol Propionate | 19 | $2,239 |
| SsdSilver Sulfadiazine | 123 | $2,082 |
| Autoshield Duo Pen NeedlePen Needle,dual Safety,diabetc | 14 | $1,412 |
| Lantus SolostarInsulin Glargine,hum.Rec.Anlog | 27 | $820 |
| Silver Sulfadiazine | 31 | $807 |
| Fluconazole | 36 | $486 |
| Doxycycline Hyclate | 31 | $450 |
| Carvedilol | 11 | $231 |
| Triamcinolone Acetonide | 16 | $182 |
| Losartan Potassium | 12 | $119 |
| Sodium ChlorideSodium Chloride Irrig Solution | 12 | $82 |
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 |
|---|---|---|
| Smith+NephewSantyl | $118 | $9,02825 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 10th percentile of 43 plastic and reconstructive surgery providers in Kentucky.
Other plastic and reconstructive surgery in Louisville
- Brian ThorntonLouisville$1.1M
- Mark CharikerLouisville$48K
- Tathyana FenstererLouisville$19K
- Joseph BanisLouisville$15K
- Angela PrescottLouisville$7K
- Terry McCurryLouisville$6K
- Thomas OdanielLouisville$5K
- Bradon WilhelmiLouisville$5K
- Joshua SpiegelLouisville$4K
- Dexter WeeksLouisville$3K
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.