Lamiere Downing, MD
Surgery · Christiansburg, VANPI 1699750976
Payments from drug & device makers
What this record shows
This record is dominated by speaking fees: $136,900 of the $174,975 with a category attached, or 78.2%. Boston Scientific accounts for 68.1% of it on its own, with 3 other manufacturers making up the rest. 2025 is the largest year on record at $119,628, more than ten times the $1,175 reported in 2019. Among surgery clinicians in VA 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 127 payments — averaging $1377.76 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Boston Scientific$119K
- Silk Road Medical, Inc.$54K
- Medtronic$2K
- Lifenet Health$22
What the payments were for
- Consulting fees$20,06311%
- Speaking & faculty fees$136,90078%
- Travel & lodging$15,1359%
- Food & beverage$2,8782%
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 |
|---|---|---|
| Boston Scientific | 70 | $119,164 |
| Silk Road Medical, Inc. | 43 | $54,112 |
| Medtronic(2 entities) | 13 | $1,677 |
| Lifenet Health | 1 | $22 |
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
$174,975 in reported general payments places this provider in the 95th percentile of 675 surgery 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 |
|---|---|---|
| ClopidogrelClopidogrel Bisulfate | 232 | $1,802 |
| Cilostazol | 48 | $657 |
| Cephalexin | 31 | $280 |
| Atorvastatin Calcium | 49 | $236 |
| Oxycodone-AcetaminophenOxycodone Hcl/Acetaminophen | 27 | $98 |
| Hydrocodone-AcetaminophenHydrocodone/Acetaminophen | 35 | $92 |
Paid to pharmacies, not to this prescriber.
Other surgery in Christiansburg
- Raymond MakhoulRichmond$1.5M
- Zobair YounossiFalls Church$1.2M
- Yassar YoussefNorfolk$1M
- David WeintrittAlexandria$555K
- Hazem ElarinyVienna$368K
- George GillianLorton$214K
- Joseph GreeneReston$187K
- Amanda CoxSalem$142K
- Christopher NorthupCharlottesville$117K
- James BittnerSuffolk$101K
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.