Lachara Livingston, MD
Allergy & Immunology · Richmond, VANPI 1780973040
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 99.0% of the total across 370 separate payments, which is the pattern of a clinician who attends manufacturer presentations rather than one with a consulting arrangement. It is spread thinly across 26 manufacturers, the largest accounting for just 17.0% — the pattern of someone who eats at a lot of different presentations. 2025 is the largest year on record at $2,069, 2.7 times the $763 reported in 2019.
Across 370 payments — averaging $18.98 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- AstraZeneca$1K
- Regeneron Healthcare Solutions, Inc.$1K
- GSK$790
- CSL Behring$623
- Novartis$582
- Genentech USA, Inc.$527
- plus $2K from 20 others
What the payments were for
- Food & beverage$6,95399%
- Education$711%
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 |
|---|---|---|
| AstraZeneca | 65 | $1,197 |
| Regeneron Healthcare Solutions, Inc. | 54 | $1,167 |
| GSK | 43 | $790 |
| CSL Behring | 31 | $623 |
| Novartis | 30 | $582 |
| Genentech USA, Inc. | 34 | $527 |
| Sanofi | 23 | $456 |
| Kaleo, Inc. | 15 | $273 |
| Grifols USA, LLC | 11 | $250 |
| Takeda Pharmaceuticals U.S.A., Inc. | 8 | $161 |
| ARS Pharmaceuticals Operations, Inc. | 10 | $145 |
| Amgen | 6 | $137 |
| Boehringer Ingelheim | 6 | $115 |
| Pfizer | 7 | $115 |
| Blueprint Medicines Corporation | 5 | $96 |
| Incyte Corporation | 3 | $56 |
| Optinose US, Inc. | 3 | $48 |
| Aimmune Therapeutics, Inc. | 2 | $45 |
| Pharming Healthcare, Inc. | 3 | $44 |
| Ionis Pharmaceuticals, Inc. | 2 | $41 |
| Hikma Pharmaceuticals USA | 2 | $34 |
| Teva Pharmaceuticals USA, Inc. | 2 | $32 |
| Merck | 2 | $32 |
| Alk-abello, Inc | 1 | $23 |
| Lilly USA, LLC | 1 | $21 |
| Biocryst US Sales Co., LLC | 1 | $15 |
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.
- NUCALA$117
How this compares
$7,024 in reported general payments places this provider in the 60th percentile of 133 allergy & immunology providers in Virginia.
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 |
|---|---|---|
| TezspireTezepelumab-Ekko | 11 | $46,263 |
| Trelegy ElliptaFluticasone/Umeclidin/Vilanter | 31 | $39,275 |
| Spiriva RespimatTiotropium Bromide | 15 | $15,573 |
| Breztri AerosphereBudesonide/Glycopyr/Formoterol | 11 | $8,063 |
| Budesonide-Formoterol FumarateBudesonide/Formoterol Fumarate | 22 | $6,732 |
| Epinephrine | 26 | $4,408 |
| Wixela InhubFluticasone Propion/Salmeterol | 33 | $4,180 |
| Advair HfaFluticasone Propion/Salmeterol | 12 | $3,546 |
| Azelastine Hcl | 88 | $2,672 |
| Fluticasone-SalmeterolFluticasone Propion/Salmeterol | 15 | $2,032 |
| Ipratropium Bromide | 53 | $2,022 |
| Montelukast Sodium | 173 | $1,582 |
| Albuterol Sulfate HfaAlbuterol Sulfate | 47 | $1,479 |
| Fluticasone Propionate | 68 | $1,001 |
| Levocetirizine Dihydrochloride | 35 | $369 |
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 |
|---|---|---|
| AstraZenecaTezspire, Breztri Aerosphere | $1,197 | $54,32622 claims |
| GSKTrelegy Ellipta | $790 | $39,27531 claims |
| Boehringer IngelheimSpiriva Respimat | $115 | $15,57315 claims |
| Hikma Pharmaceuticals USAEpinephrine | $34 | $4,40826 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 60th percentile of 133 allergy & immunology providers in Virginia.
Other allergy & immunology in Richmond
- Michael BlumbergRichmond$32K
- Balraj BajajRichmond$8K
- William EschenbacherRichmond$8K
- Kelley von EltenRichmond$5K
- Charles LaneLynchburg$1.4M
- Jacqueline Eghrari-SabetVienna$1M
- Eric KarlinWilliamsburg$522K
- Nicholas RiderRoanoke$227K
- Courtney BlairMc Lean$139K
- Andrew KimFredericksburg$104K
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.