Joseph Toothaker Alvarez, MD
Pain Medicine · Webster, TXNPI 1336193903
Payments from drug & device makers
Across 351 payments — averaging $66.75 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Medtronic$16K
- Abbott$2K
- Vertiflex, Inc.$1K
- Boston Scientific$1K
- Nevro Corp.$823
- Biotronik NRO, Inc.$477
- plus $2K from 27 others
What the payments were for
- Speaking & faculty fees$1,2505%
- Travel & lodging$6873%
- Food & beverage$21,24091%
- Education$50%
- Entertainment$2481%
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 |
|---|---|---|
| Medtronic(2 entities) | 197 | $15,756 |
| Abbott | 33 | $2,146 |
| Vertiflex, Inc. | 13 | $1,412 |
| Boston Scientific | 34 | $1,174 |
| Nevro Corp. | 17 | $823 |
| Biotronik NRO, Inc. | 9 | $477 |
| Si-bone, Inc. | 5 | $259 |
| Flowonix Medical Incorporated | 1 | $248 |
| AbbVie(2 entities) | 9 | $219 |
| Amgen(2 entities) | 4 | $187 |
| Saluda Medical Americas, Inc. | 2 | $146 |
| Vertos Medical, Inc. | 1 | $113 |
| Sentynl Therapeutics, Inc. | 3 | $43 |
| Tersera Therapeutics LLC | 2 | $41 |
| Salix Pharmaceuticals, A Division Of Bausch Health US, LLC | 2 | $36 |
| Collegium Pharmaceutical, Inc. | 2 | $30 |
| Pacira Therapeutics, Inc. | 1 | $27 |
| GRT US Holding, Inc. | 1 | $26 |
| Vertex | 1 | $25 |
| Inspire Medical Systems, Inc. | 1 | $22 |
| Bioventus LLC | 1 | $21 |
| Daiichi Sankyo Inc. | 1 | $21 |
| Nalu Medical, Inc. | 1 | $20 |
| Vertical Pharmaceuticals, LLC | 1 | $19 |
| Electronic Waveform Lab, Inc. | 1 | $19 |
| Azurity Pharmaceuticals, Inc. | 1 | $18 |
| Painteq LLC | 1 | $18 |
| Scilex Pharmaceuticals Inc. | 1 | $17 |
| Lilly USA, LLC | 1 | $16 |
| Almatica Pharma LLC | 1 | $16 |
| Baudax Bio Inc. | 1 | $12 |
| Biodelivery Sciences International, Inc. | 1 | $12 |
| Arbor Pharmaceuticals, Inc. | 1 | $11 |
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.
- INTELLIS ADAPTIVESTIM$4,092
- Accurian$1,382
- Superion ISS$1,181
- Proclaim Family of SCS IPGs$803
- INCEPTIV$681
- SYNCHROMEDII$622
- INTELLIS$398
- Prospera$286
- RESTORE$274
- SYNCHROMED$270
- Prometra II$248
- Senza Spinal Cord Stimulation System$241
- SUPERION$216
- VANTA ADAPTIVESTIM$158
- Proclaim IPG$141
- Senza$127
- Evoke$117
- mild Device Kit$113
- ACTIVA$107
- Omnia$107
How this compares
$23,430 in reported general payments places this provider in the 85th percentile of 583 pain medicine 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 |
|---|---|---|
| Nucynta ErTapentadol Hcl | 28 | $40,671 |
| Hydrocodone-AcetaminophenHydrocodone/Acetaminophen | 563 | $15,571 |
| Fentanyl | 79 | $7,086 |
| Morphine Sulfate ErMorphine Sulfate | 149 | $4,279 |
| Pregabalin | 197 | $3,274 |
| Hydromorphone Hcl | 91 | $2,113 |
| Gabapentin | 138 | $1,653 |
| Morphine Sulfate | 50 | $1,429 |
| Acetaminophen-CodeineAcetaminophen With Codeine | 55 | $1,154 |
| Lidocaine | 21 | $992 |
| Methocarbamol | 70 | $935 |
| Tramadol Hcl | 116 | $785 |
| Oxycodone-AcetaminophenOxycodone Hcl/Acetaminophen | 37 | $618 |
| Butalbital-Acetaminophen-CaffeButalb/Acetaminophen/Caffeine | 11 | $541 |
| Carisoprodol | 25 | $535 |
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 |
|---|---|---|
| Collegium Pharmaceutical, Inc.Nucynta Er | $30 | $40,67128 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 85th percentile of 583 pain medicine providers in Texas.
Other pain medicine in Webster
- Eduardo GarciaWebster$193K
- Mohamad AzzamWebster$51K
- Steven CannellaWebster$28K
- Aaron CalodneyTyler$3M
- Mitchell EngleHouston$1.5M
- Melissa MurphyGrapevine$711K
- Shiraz YazdaniLubbock$632K
- Muhammad ZulqarnainDallas$556K
- Daniel PakHouston$460K
- Marvin ChangSugar Land$306K
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.