Lawrence Alder, MD
Internal Medicine · Kerrville, TXNPI 1023027182
Payments from drug & device makers
Across 153 payments — averaging $21.76 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- AstraZeneca$823
- AbbVie$792
- Novo Nordisk$277
- Lilly USA, LLC$198
- Inspire Medical Systems, Inc.$196
- Merck$143
- plus $900 from 20 others
What the payments were for
- Food & beverage$3,314100%
- Education$150%
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 | 22 | $823 |
| AbbVie(2 entities) | 46 | $792 |
| Novo Nordisk | 20 | $277 |
| Lilly USA, LLC | 10 | $198 |
| Inspire Medical Systems, Inc. | 3 | $196 |
| Merck | 9 | $143 |
| Gilead | 1 | $125 |
| Johnson & Johnson | 3 | $119 |
| Novartis | 8 | $118 |
| Amgen | 4 | $70 |
| Pfizer | 4 | $65 |
| Exact Sciences | 3 | $55 |
| Takeda Pharmaceuticals U.S.A., Inc. | 3 | $48 |
| Medtronic | 1 | $38 |
| Teva Pharmaceuticals USA, Inc. | 2 | $33 |
| GSK | 2 | $32 |
| Sanofi Pasteur Inc. | 2 | $31 |
| E.r. Squibb & Sons, L.L.C. | 2 | $26 |
| Axsome Therapeutics, Inc. | 1 | $26 |
| Kowa Pharmaceuticals America, Inc. | 1 | $21 |
| Alk-abello, Inc | 1 | $18 |
| Lundbeck LLC | 1 | $17 |
| Amarin Pharma, Inc. | 1 | $16 |
| Boehringer Ingelheim | 1 | $15 |
| Salix Pharmaceuticals, A Division Of Bausch Health US, LLC | 1 | $15 |
| Esperion Therapeutics, Inc. | 1 | $11 |
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
$3,329 in reported general payments places this provider in the 80th percentile of 7,675 internal medicine 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 |
|---|---|---|
| CalquenceAcalabrutinib Maleate | 13 | $200,810 |
| OzempicSemaglutide | 172 | $194,512 |
| JardianceEmpagliflozin | 46 | $60,485 |
| EliquisApixaban | 70 | $58,987 |
| Dupixent SyringeDupilumab | 12 | $55,143 |
| MounjaroTirzepatide | 44 | $51,390 |
| Trelegy ElliptaFluticasone/Umeclidin/Vilanter | 60 | $46,745 |
| FarxigaDapagliflozin Propanediol | 46 | $45,019 |
| XareltoRivaroxaban | 28 | $34,667 |
| TrulicityDulaglutide | 23 | $27,578 |
| Breztri AerosphereBudesonide/Glycopyr/Formoterol | 23 | $19,906 |
| MyrbetriqMirabegron | 22 | $17,850 |
| JanuviaSitagliptin Phosphate | 14 | $16,470 |
| EntrestoSacubitril/Valsartan | 13 | $9,733 |
| Breo ElliptaFluticasone/Vilanterol | 11 | $7,698 |
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 |
|---|---|---|
| AstraZenecaCalquence, Farxiga, Breztri Aerosphere, Symbicort | $823 | $271,340104 claims |
| Novo NordiskOzempic | $277 | $194,512172 claims |
| Lilly USA, LLCMounjaro, Trulicity | $198 | $78,96867 claims |
| PfizerEliquis, Premarin | $65 | $65,64083 claims |
| Boehringer IngelheimJardiance | $15 | $60,48546 claims |
| GSKTrelegy Ellipta, Breo Ellipta | $32 | $54,44471 claims |
| Johnson & JohnsonXarelto | $119 | $34,66728 claims |
| MerckJanuvia | $143 | $16,47014 claims |
| NovartisEntresto | $118 | $9,73313 claims |
| AbbVieSynthroid | $792 | $3,23963 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 80th percentile of 7,675 internal medicine providers in Texas.
Other internal medicine in Kerrville
- Jan BurgerHouston$47.3M
- Nitin JainHouston$33.2M
- Muhammad IrfanTomball$30.6M
- Aung NaingHouston$30.6M
- Robert BassSan Antonio$25.6M
- Preetesh JainHouston$19.5M
- Paolo StratiHouston$19.2M
- Hernan SalazarSan Antonio$18.5M
- Nicholas ShortHouston$17.6M
- Salma SaigerMesquite$16.1M
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.