Lawrence Ciesemier, DO
Allergy & Immunology · Kirksville, MONPI 1952464190
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 96.2% of the total across 544 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 31 manufacturers, the largest accounting for just 19.0% — the pattern of someone who eats at a lot of different presentations.
Across 544 payments — averaging $18.33 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- AstraZeneca$2K
- Takeda Pharmaceuticals U.S.A., Inc.$1K
- CSL Behring$1K
- GSK$869
- Grifols USA, LLC$832
- Regeneron Healthcare Solutions, Inc.$768
- plus $3K from 25 others
What the payments were for
- Consulting fees$240%
- Food & beverage$9,59696%
- Education$3534%
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 | 96 | $1,895 |
| Takeda Pharmaceuticals U.S.A., Inc. | 96 | $1,173 |
| CSL Behring | 65 | $1,064 |
| GSK | 50 | $869 |
| Grifols USA, LLC | 48 | $832 |
| Regeneron Healthcare Solutions, Inc. | 26 | $768 |
| Sanofi | 24 | $582 |
| Amgen(2 entities) | 17 | $428 |
| Mylan Specialty L.p. | 22 | $414 |
| Genentech USA, Inc. | 17 | $330 |
| Novartis | 14 | $294 |
| Verona Pharma, Inc. | 6 | $124 |
| Shire North American Group Inc | 12 | $121 |
| Pfizer | 7 | $120 |
| Sanofi-aventis U.S. LLC | 2 | $118 |
| Boehringer Ingelheim | 7 | $113 |
| ARS Pharmaceuticals Operations, Inc. | 4 | $94 |
| Hospira, Inc. | 6 | $89 |
| Viatris Specialty LLC | 4 | $79 |
| Teva Pharmaceuticals USA, Inc. | 4 | $75 |
| Blueprint Medicines Corporation | 3 | $74 |
| Mallinckrodt Hospital Products Inc. | 1 | $66 |
| Octapharma USA, Inc. | 2 | $43 |
| Genentech, Inc. | 1 | $38 |
| Merck | 2 | $35 |
| Bio Products Laboratory USA, Inc. | 2 | $34 |
| Biocryst US Sales Co., LLC | 2 | $25 |
| ADMA Biomanufacturing LLC | 1 | $24 |
| Paratek Pharmaceuticals, Inc. | 1 | $19 |
| Electromed, Inc. | 1 | $17 |
| AbbVie | 1 | $16 |
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
$9,973 in reported general payments places this provider in the 75th percentile of 61 allergy & immunology providers in Missouri.
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 |
|---|---|---|
| Dupixent PenDupilumab | 20 | $75,089 |
| XolairOmalizumab | 13 | $70,943 |
| Trelegy ElliptaFluticasone/Umeclidin/Vilanter | 95 | $69,520 |
| Breo ElliptaFluticasone/Vilanterol | 134 | $56,935 |
| NucalaMepolizumab | 13 | $54,890 |
| Breztri AerosphereBudesonide/Glycopyr/Formoterol | 30 | $17,891 |
| Combivent RespimatIpratropium/Albuterol Sulfate | 30 | $13,915 |
| Advair HfaFluticasone Propion/Salmeterol | 31 | $11,941 |
| Arnuity ElliptaFluticasone Furoate | 35 | $9,593 |
| Epinephrine | 31 | $6,801 |
| Spiriva RespimatTiotropium Bromide | 11 | $5,451 |
| DuleraMometasone/Formoterol | 13 | $5,082 |
| Advair DiskusFluticasone Propion/Salmeterol | 20 | $5,038 |
| SymbicortBudesonide/Formoterol Fumarate | 18 | $4,807 |
| Ipratropium Bromide | 106 | $2,741 |
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 |
|---|---|---|
| GSKTrelegy Ellipta, Breo Ellipta, Nucala, Arnuity Ellipta | $869 | $190,938277 claims |
| Genentech, Inc.Xolair | $38 | $70,94313 claims |
| AstraZenecaBreztri Aerosphere, Symbicort | $1,895 | $22,69848 claims |
| Boehringer IngelheimCombivent Respimat, Spiriva Respimat | $113 | $19,36741 claims |
| MerckDulera | $35 | $5,08213 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 75th percentile of 61 allergy & immunology providers in Missouri.
Other allergy & immunology in Kirksville
- H James WednerSaint Louis$420K
- Manoj WarrierSaint Louis$316K
- Jeffrey TillinghastSaint Louis$278K
- Lanny RosenwasserKansas City$46K
- Aaron Ver HeulSaint Louis$28K
- Peggy KendallSaint Louis$20K
- Brett HronekSpringfield$20K
- Minh Thu leSpringfield$19K
- Michael BortsSaint Louis$17K
- Jeremy KatcherSaint Louis$16K
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.