Kristopher Downing, MD
Orthopaedic Surgery · la Jolla, CANPI 1851451439
Payments from drug & device makers
What this record shows
This record is dominated by other: $151,694 of the $170,539 with a category attached, or 88.9%. Encore Medical, LP accounts for 88.9% of it on its own, with 38 other manufacturers making up the rest. Reporting peaked in 2021 at $152,908 and has fallen 99.1% since, to $1,373 in 2025. Among orthopaedic surgery clinicians in CA with any reported payments, this total sits in the top 10% — high for the specialty, which is a reason to read the composition above rather than the number alone.
Across 134 payments — averaging $1272.68 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Encore Medical, LP$152K
- Axogen$3K
- Arthrex$3K
- Sportstek Medical, Inc$2K
- Trice Medical, Inc.$2K
- Stryker$2K
- plus $7K from 33 others
What the payments were for
- Consulting fees$2,0251%
- Travel & lodging$3,7612%
- Food & beverage$9,4216%
- Education$3,6382%
- Other$151,69489%
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 |
|---|---|---|
| Encore Medical, LP | 1 | $151,694 |
| Axogen | 9 | $3,045 |
| Arthrex | 24 | $2,843 |
| Sportstek Medical, Inc | 2 | $2,438 |
| Trice Medical, Inc. | 2 | $2,025 |
| Stryker(2 entities) | 16 | $1,555 |
| Trimed, Inc. | 2 | $1,522 |
| Elevate Surgical Co | 14 | $1,456 |
| Kls-martin L.p. | 7 | $1,376 |
| Shoulder Innovations, Inc. | 2 | $419 |
| Catalyst Orthoscience | 2 | $285 |
| Johnson & Johnson | 9 | $212 |
| Linvatec Corporation | 1 | $199 |
| Endo Pharmaceuticals Inc. | 3 | $145 |
| Impactortho, Inc. | 2 | $145 |
| Bioventus LLC | 8 | $135 |
| Smith+Nephew | 3 | $120 |
| Acumed LLC | 1 | $115 |
| Illuminoss Medical, Inc. | 3 | $105 |
| FX Shoulder Solutions, Inc | 1 | $97 |
| Medartis Inc. | 1 | $95 |
| Skeletal Dynamics Inc | 2 | $84 |
| Zimmer Biomet | 2 | $62 |
| Kerecis Limited | 1 | $52 |
| Integra Lifesciences Corporation | 2 | $47 |
| Bsn Medical Inc | 1 | $39 |
| Heraeus Medical, LLC. | 1 | $23 |
| Nevro Corp. | 1 | $22 |
| Medtronic | 1 | $20 |
| Abbott | 1 | $20 |
| ERMI LLC | 1 | $19 |
| Amgen | 1 | $19 |
| Orthofix Medical, Inc. | 1 | $19 |
| Endo USA, Inc. | 1 | $17 |
| Biotissue Holdings Inc. | 1 | $16 |
| Acell, Inc. | 1 | $15 |
| Arthrosurface Incorporated | 1 | $14 |
| Pacira Pharmaceuticals Incorporated | 1 | $14 |
| Lilly USA, LLC | 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.
- AxoGuard Nerve Connector$2,876
- AxoGuard Nerve Protector$2,876
- Segway blade or mieye camera$2,025
- AVANCE NERVE GRAFT$434
- InSet System$419
- GAMMA$292
- ACUMED$229
- BioBrace 23mm$199
- Catalyst Total CSR$183
- T2 ALPHA$172
- AEQUALIS PERFORM REVERSED$164
- OMEGA$154
- EZOUT$154
- TRIATHLON$154
- AEQUALIS PERFORM$133
- PANGEA$131
- MAKO$125
- XIAFLEX$119
How this compares
$170,539 in reported general payments places this provider in the 90th percentile of 1,808 orthopaedic surgery providers in California.
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 |
|---|---|---|
| Hydrocodone-AcetaminophenHydrocodone/Acetaminophen | 46 | $318 |
| Ibuprofen | 73 | $251 |
| Meloxicam | 40 | $202 |
| Oxycodone-AcetaminophenOxycodone Hcl/Acetaminophen | 22 | $107 |
| Tramadol Hcl | 27 | $72 |
Paid to pharmacies, not to this prescriber.
Other orthopaedic surgery in la Jolla
- Robert Eastlackla Jolla$3.9M
- Behrooz Akbarniala Jolla$2.6M
- James Bruffeyla Jolla$1.1M
- Bradford HackArcadia$18.3M
- Robert GorabOrange$13.6M
- Kelly VinceLos Angeles$9.6M
- Stephen HowellSacramento$9.4M
- Thomas CoonRed Bluff$9.2M
- Nirav AminPlacentia$5.6M
- Tom NorrisSan Francisco$5.3M
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.