Julie Romeis, PA
Physician Assistant · Cary, NCNPI 1033756598
Payments from drug & device makers
What this record shows
The money is spread across several categories — speaking fees (57.4%), food and beverage and consulting fees — rather than concentrated in one kind of arrangement. 30 manufacturers reported payments, led by Otsuka America Pharmaceutical, Inc. at 33.3% of the total. 2025 is the largest year on record at $34,208, more than ten times the $1,399 reported in 2021. Among physician assistant clinicians in NC with any reported payments, this total sits in the top 5% — high for the specialty, which is a reason to read the composition above rather than the number alone.
Across 501 payments — averaging $91.21 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Otsuka America Pharmaceutical, Inc.$15K
- Axsome Therapeutics, Inc.$14K
- ITI, Inc. (d/b/a Intra-cellular Therapies, Inc.)$6K
- AbbVie$3K
- Alkermes, Inc.$2K
- USWM, LLC$1K
- plus $5K from 24 others
What the payments were for
- Consulting fees$2,5005%
- Speaking & faculty fees$26,22657%
- Travel & lodging$2,1925%
- Food & beverage$13,27729%
- Education$890%
- Gifts$1,4143%
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 |
|---|---|---|
| Otsuka America Pharmaceutical, Inc. | 54 | $15,220 |
| Axsome Therapeutics, Inc. | 32 | $13,532 |
| ITI, Inc. (d/b/a Intra-cellular Therapies, Inc.) | 69 | $6,448 |
| AbbVie | 138 | $2,604 |
| Alkermes, Inc. | 67 | $1,535 |
| USWM, LLC | 6 | $1,480 |
| Teva Pharmaceuticals USA, Inc. | 36 | $1,441 |
| Neurocrine Biosciences, Inc. | 23 | $1,304 |
| Johnson & Johnson | 21 | $739 |
| Vanda Pharmaceuticals Inc. | 5 | $221 |
| Idorsia Pharmaceuticals US Inc | 4 | $175 |
| E.r. Squibb & Sons, L.L.C. | 2 | $132 |
| Indivior Inc. | 7 | $125 |
| Bayer | 1 | $117 |
| Lundbeck LLC | 6 | $101 |
| Sunovion Pharmaceuticals Inc. | 6 | $91 |
| Takeda Pharmaceuticals U.S.A., Inc. | 5 | $90 |
| Neos Therapeutics, LP | 4 | $74 |
| Bausch Health US, LLC | 3 | $62 |
| Noven Therapeutics, LLC | 2 | $38 |
| Livanova USA, Inc. | 1 | $22 |
| Eisai Inc. | 1 | $19 |
| Brainsway USA Inc | 1 | $19 |
| Orexo US, Inc. | 1 | $19 |
| Lilly USA, LLC | 1 | $17 |
| TMS Neurohealth Centers Inc. | 1 | $17 |
| Collegium Pharmaceutical, Inc. | 1 | $15 |
| Ironshore Pharmaceuticals Inc. | 1 | $15 |
| Tris Pharma Inc | 1 | $14 |
| Supernus Pharmaceuticals, Inc. | 1 | $13 |
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
$45,697 in reported general payments places this provider in the 95th percentile of 7,441 physician assistant providers in North Carolina.
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 |
|---|---|---|
| CaplytaLumateperone Tosylate | 30 | $49,935 |
| VraylarCariprazine Hcl | 30 | $42,866 |
| RexultiBrexpiprazole | 19 | $34,882 |
| TrintellixVortioxetine Hydrobromide | 26 | $14,702 |
| DayvigoLemborexant | 12 | $3,968 |
| Dextroamphetamine-Amphet ErDextroamphetamine/Amphetamine | 25 | $2,971 |
| Bupropion XlBupropion Hcl | 55 | $1,948 |
| Lamotrigine | 69 | $909 |
| Quetiapine Fumarate | 17 | $892 |
| Nortriptyline Hcl | 40 | $704 |
| Desvenlafaxine Succinate ErDesvenlafaxine Succinate | 16 | $556 |
| Oxcarbazepine | 12 | $494 |
| Methylphenidate ErMethylphenidate Hcl | 15 | $470 |
| Duloxetine Hcl | 33 | $428 |
| Propranolol Hcl | 32 | $341 |
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 |
|---|---|---|
| ITI, Inc. (d/b/a Intra-cellular Therapies, Inc.)Caplyta | $6,448 | $49,93530 claims |
| AbbVieVraylar | $2,604 | $42,86630 claims |
| Otsuka America Pharmaceutical, Inc.Rexulti | $15,220 | $34,88219 claims |
| Takeda Pharmaceuticals U.S.A., Inc.Trintellix | $90 | $14,70226 claims |
| Eisai Inc.Dayvigo | $19 | $3,96812 claims |
| Lilly USA, LLCOlanzapine | $17 | $17113 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 95th percentile of 7,441 physician assistant providers in North Carolina.
Other physician assistant in Cary
- Jennifer HellingerCary$41K
- Jo HughesGreensboro$814K
- Rachel HolzhauerCharlotte$739K
- Amber BlairCharlotte$551K
- Benjamin EpsteinDavidson$447K
- Rebecca KrausDavidson$425K
- Brooke JonesGoldsboro$259K
- Philip ReasbeckWilson$180K
- Katherine SchultzHuntersville$164K
- Kristin CabedaCharlotte$135K
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.