Lauren Karbach, MD
Surgery of the Hand · San Antonio, TXNPI 1013350164
Payments from drug & device makers
What this record shows
The money is spread across several categories — travel and lodging (53.4%), food and beverage and education — rather than concentrated in one kind of arrangement. 15 manufacturers reported payments, led by Trimed, Inc. at 30.4% of the total. Reporting peaked in 2020 at $3,054 and has fallen 99.3% since, to $21 in 2025.
Across 34 payments — averaging $209.01 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Trimed, Inc.$2K
- Acumed LLC$2K
- Encore Medical, LP$1K
- Crossroads Orthopedics, LLC$816
- Axogen$510
- Integra Lifesciences Corporation$389
- plus $724 from 9 others
What the payments were for
- Travel & lodging$3,79853%
- Food & beverage$2,49235%
- Education$81611%
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 |
|---|---|---|
| Trimed, Inc. | 3 | $2,157 |
| Acumed LLC | 6 | $1,506 |
| Encore Medical, LP | 7 | $1,006 |
| Crossroads Orthopedics, LLC | 1 | $816 |
| Axogen | 1 | $510 |
| Integra Lifesciences Corporation | 3 | $389 |
| Stryker | 4 | $183 |
| Radius Health, Inc. | 1 | $125 |
| Endo Pharmaceuticals Inc. | 2 | $123 |
| Exactech, Inc. | 1 | $83 |
| Zimmer Biomet | 1 | $81 |
| DJO, LLC | 1 | $47 |
| Skeletal Dynamics Inc | 1 | $39 |
| Kerecis Limited | 1 | $22 |
| Johnson & Johnson | 1 | $21 |
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.
- ACUMED$5,381
- OsteoMed$1,660
- DJO Surgical AltiVate Reverse$535
- AxoGuard Nerve Protector$510
- AxoGuard Nerve Connector$510
- FREEDOM WRIST$356
- PYRO MCP$356
- TSSM - TOTAL SHOULDER SYSTEM METAL$356
- TITAN-SHOULDER$356
- External Fixation System$356
- DJO SURGICAL$266
- Tymlos$125
- DJO Surgical Discovery Elbow System$124
- DJO Surgical AltiVate Anatomic System$117
- XIAFLEX$111
How this compares
$7,106 in reported general payments places this provider in the 75th percentile of 68 surgery of the hand providers in Texas.
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 | 63 | $647 |
| Tramadol Hcl | 29 | $114 |
Paid to pharmacies, not to this prescriber.
Other surgery of the hand in San Antonio
- Suresh KoneruSan Antonio$17K
- Michael JonesSan Antonio$9K
- Roberto MartinezSan Antonio$8K
- Kunj DesaiSan Antonio$6K
- Anthony MontanezSan Antonio$4K
- Woodward ColemanSan Antonio$3K
- Christian WoodburySan Antonio$2K
- Stephen DrukkerSan Antonio$424
- Desirae McKeeLubbock$59K
- Stuart HilliardDenton$21K
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.