Lance Keck, PA
Physician Assistant · Tacoma, WANPI 1174793590
Payments from drug & device makers
What this record shows
This record is dominated by education: $110,850 of the $162,107 with a category attached, or 68.4%. Intuitive Surgical accounts for 99.9% of it on its own, with 3 other manufacturers making up the rest. Among physician assistant clinicians in WA 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 416 payments — averaging $389.68 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Intuitive Surgical$162K
- Getinge USA Sales, LLC$127
- LSI Solutions Inc$29
- BD$18
What the payments were for
- Travel & lodging$49,92731%
- Food & beverage$1,3301%
- Education$110,85068%
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 |
|---|---|---|
| Intuitive Surgical | 409 | $161,933 |
| Getinge USA Sales, LLC | 5 | $127 |
| LSI Solutions Inc | 1 | $29 |
| BD | 1 | $18 |
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.
- Da Vinci Surgical System$157,549
How this compares
$162,107 in reported general payments places this provider in the 95th percentile of 2,741 physician assistant providers in Washington.
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 |
|---|---|---|
| Amiodarone Hcl | 16 | $200 |
| Gabapentin | 27 | $197 |
| Oxycodone Hcl | 30 | $171 |
| Metoprolol Succinate | 26 | $120 |
| ClopidogrelClopidogrel Bisulfate | 15 | $92 |
| Tramadol Hcl | 23 | $88 |
| Pantoprazole Sodium | 18 | $79 |
| Potassium Chloride | 20 | $52 |
| Atorvastatin Calcium | 17 | $45 |
| Furosemide | 23 | $27 |
Paid to pharmacies, not to this prescriber.
Other physician assistant in Tacoma
- Joanna NguyenTacoma$16K
- Tory FossTacoma$8K
- Sharon BarkerTacoma$8K
- Bert BakerTacoma$7K
- Jill KandoraShoreline$437K
- Jeannette HartRichland$263K
- Erinn KingSeattle$129K
- Christy VathSeattle$75K
- Scott TaylorMercer Island$71K
- Gina FragioneGraham$69K
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.