Julia Koestner, NP
Obstetrics & Gynecology · Paw Paw, MINPI 1760460562
Payments from drug & device makers
Across 25 payments — averaging $21.18 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Exeltis, USA Inc.$121
- Daiichi Sankyo Inc.$116
- AbbVie$81
- Pfizer$51
- Bayer$46
- Astellas Pharma US Inc$44
- plus $70 from 4 others
What the payments were for
- Food & beverage$530100%
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 |
|---|---|---|
| Exeltis, USA Inc. | 6 | $121 |
| Daiichi Sankyo Inc. | 3 | $116 |
| AbbVie | 4 | $81 |
| Pfizer | 3 | $51 |
| Bayer | 3 | $46 |
| Astellas Pharma US Inc | 2 | $44 |
| Minerva Surgical, Inc | 1 | $19 |
| Organon | 1 | $19 |
| Hologic Sales And Service, LLC | 1 | $18 |
| Sumitomo Pharma America, Inc. | 1 | $14 |
How this compares
$530 in reported general payments places this provider in the 50th percentile of 1,474 obstetrics & gynecology providers in Michigan.
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 |
|---|---|---|
| Estradiol | 99 | $4,891 |
| Tolterodine Tartrate ErTolterodine Tartrate | 34 | $2,782 |
| Clobetasol EmollientClobetasol Propionate/Emoll | 14 | $1,065 |
| ValacyclovirValacyclovir Hcl | 14 | $962 |
| Minocycline Hcl | 22 | $815 |
| Clobetasol Propionate | 28 | $677 |
| Solifenacin Succinate | 28 | $581 |
| Betamethasone Valerate | 19 | $559 |
| Terconazole | 13 | $337 |
| Alendronate Sodium | 29 | $333 |
| Nystatin | 12 | $140 |
| Norgestimate-Ethinyl Estradiol | 12 | $118 |
| Medroxyprogesterone Acetate | 11 | $111 |
| Oxybutynin Chloride | 13 | $66 |
| Fluconazole | 17 | $54 |
Paid to pharmacies, not to this prescriber.
Other obstetrics & gynecology in Paw Paw
- Haider MahdiDetroit$3.4M
- Andrew WagnerMidland$2M
- Jason BellAnn Arbor$548K
- Jacquelyn RobinsonSaginaw$539K
- Jouhaina MalehDearborn$524K
- Awoniyi AwonugaSouthfield$445K
- Rabbie HannaDetroit$421K
- David EisensteinDetroit$296K
- Duane HeilbronnSaginaw$234K
- Donna HrozencikCanton$196K
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.