Lee Birnbaum, MD
Vascular Neurology · San Antonio, TXNPI 1093739294
Payments from drug & device makers
What this record shows
This record is dominated by consulting fees: $149,822 of the $195,242 with a category attached, or 76.7%. Imperative Care, Inc accounts for 79.0% of it on its own, with 14 other manufacturers making up the rest. 2025 is the largest year on record at $66,711, more than ten times the $1,361 reported in 2019. Among vascular neurology clinicians in TX 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 351 payments — averaging $556.25 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Imperative Care, Inc$154K
- Rapid Medical Ltd$18K
- Ischemaview, Inc.$15K
- Stryker$3K
- Microvention, Inc.$2K
- Penumbra, Inc.$994
- plus $2K from 9 others
What the payments were for
- Consulting fees$149,82277%
- Travel & lodging$24,50113%
- Food & beverage$20,91911%
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 |
|---|---|---|
| Imperative Care, Inc | 192 | $154,187 |
| Rapid Medical Ltd | 36 | $18,336 |
| Ischemaview, Inc. | 5 | $14,730 |
| Stryker | 65 | $3,436 |
| Microvention, Inc. | 19 | $1,743 |
| Penumbra, Inc. | 14 | $994 |
| Medtronic(2 entities) | 7 | $641 |
| Johnson & Johnson | 4 | $321 |
| Route 92 Medical, Inc. | 2 | $305 |
| Scientia Vascular | 2 | $206 |
| Balt USA, LLC | 1 | $195 |
| Genentech, Inc. | 1 | $77 |
| Medical Device Business Services, Inc. | 1 | $33 |
| Asahi Intecc USA, Inc. | 1 | $23 |
| Perfuze Inc | 1 | $17 |
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.
- ZOOM 88-T LARGE DISTAL PLATFORM$147,616
- TIGERTRIEVER 17 REVASCULARIZATION DEVICE$17,627
- COMANECI 17$17,627
- ZOOM REPERFUSION CATHETER$2,128
- WEB Aneurysm Embolization System$1,185
- Penumbra System$610
- SURPASS EVOLVE$594
- SYMPHONY CATHETER$590
- ZOOM CATHETER$545
- TARGET$514
- WINGSPAN$487
- ZOOM RDL RADIAL ACCESS SYSTEM, 103CM$443
- Pipeline$410
- STENT$347
- 8F Base Camp Sheath System$305
- ATLAS$287
- HYDROSOFT ADVANCED$284
- Benchmark$281
- BROADWAY 8$277
- TREVO$260
How this compares
$195,242 in reported general payments places this provider in the 95th percentile of 76 vascular neurology 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 |
|---|---|---|
| ClopidogrelClopidogrel Bisulfate | 16 | $91 |
Paid to pharmacies, not to this prescriber.
Other vascular neurology in San Antonio
- Andrew SlusherSan Antonio$203
- Ameer HassanHarlingen$1M
- John VolpiHouston$407K
- Amrou SarrajHouston$182K
- Sunil ShethHouston$54K
- Steven WarachAustin$32K
- Jefferson MileyAustin$28K
- Hamidreza SaberAustin$22K
- Haris KamalHouston$21K
- Sean SavitzHouston$20K
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.