Jonathan Fialkov, MD
Urology · West Des Moines, IANPI 1518951532
Payments from drug & device makers
What this record shows
The money is spread across several categories — food and beverage (59.8%), education and travel and lodging — rather than concentrated in one kind of arrangement. 14 manufacturers reported payments, led by Procept Biorobotics Corporation at 33.5% of the total. That places this record below the midpoint for urology clinicians in IA, where the typical reported total is $1,504.
Across 40 payments — averaging $37.59 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Procept Biorobotics Corporation$503
- Astellas Pharma US Inc$412
- Pfizer$184
- Coloplast$94
- Intuitive Surgical$71
- Tolmar, Inc.$60
- plus $179 from 8 others
Across 2 payments — averaging $4250.00 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.
- Sumitomo Pharma America, Inc.$9K
What the payments were for
- Travel & lodging$27218%
- Food & beverage$89960%
- Education$33322%
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 |
|---|---|---|
| Procept Biorobotics Corporation | 3 | $503 |
| Astellas Pharma US Inc | 8 | $412 |
| Pfizer | 11 | $184 |
| Coloplast | 5 | $94 |
| Intuitive Surgical | 1 | $71 |
| Tolmar, Inc. | 3 | $60 |
| Axonics, Inc. | 2 | $36 |
| Medtronic | 1 | $28 |
| Urogen Pharma, Inc. | 1 | $23 |
| Innovation Technologies Inc | 1 | $22 |
| Boston Scientific | 1 | $20 |
| Ferring Pharmaceuticals Inc. | 1 | $17 |
| Bayer | 1 | $17 |
| Tolmar Pharmaceuticals, 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.
How this compares
$1,504 in reported general payments places this provider in the 50th percentile of 114 urology providers in Iowa.
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 |
|---|---|---|
| MyrbetriqMirabegron | 69 | $27,777 |
| PremarinEstrogens, Conjugated | 18 | $8,711 |
| Tamsulosin Hcl | 536 | $8,282 |
| GemtesaVibegron | 25 | $5,096 |
| Finasteride | 351 | $4,566 |
| Testosterone | 16 | $2,699 |
| Oxybutynin Chloride ErOxybutynin Chloride | 98 | $2,574 |
| Potassium Citrate ErPotassium Citrate | 20 | $2,143 |
| Methenamine Hippurate | 14 | $2,086 |
| Estradiol | 15 | $1,702 |
| Megestrol Acetate | 39 | $1,402 |
| Alfuzosin Hcl ErAlfuzosin Hcl | 77 | $1,063 |
| Desmopressin Acetate | 13 | $832 |
| Bicalutamide | 20 | $455 |
| Oxybutynin Chloride | 37 | $395 |
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 |
|---|---|---|
| Astellas Pharma US IncMyrbetriq | $412 | $27,77769 claims |
| PfizerPremarin | $184 | $8,71118 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 50th percentile of 114 urology providers in Iowa.
Other urology in West Des Moines
- Vignesh PackiamIowa City$112K
- Annah VollstedtIowa City$66K
- Bradley EricksonIowa City$65K
- Michael OdonnellIowa City$62K
- Kevin BirusinghDes Moines$59K
- Ryan DornbierClive$55K
- Alexandria HertzIowa City$53K
- John BuieIowa City$52K
- Charles SchlaepferIowa City$51K
- Mahmoud AlameddineOttumwa$26K
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.