Ludmila Pichugena-Emerson, NP
Adult Health · Middlebury, INNPI 1447669304
Payments from drug & device makers
What this record shows
The money is spread across several categories — food and beverage (52.3%), consulting fees and travel and lodging — rather than concentrated in one kind of arrangement. 30 manufacturers reported payments, led by Insulet Corporation at 33.9% of the total. 2025 is the largest year on record at $8,312, 9.2 times the $905 reported in 2021. Among adult health clinicians in IN 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 335 payments — averaging $40.33 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Insulet Corporation$5K
- Lilly USA, LLC$3K
- Sanofi-aventis U.S. LLC$3K
- BETA Bionics, Inc.$289
- Xeris Pharmaceuticals, Inc.$286
- Abbott$271
- plus $2K from 24 others
What the payments were for
- Consulting fees$2,50019%
- Speaking & faculty fees$1,68012%
- Travel & lodging$2,26817%
- Food & beverage$7,06452%
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 |
|---|---|---|
| Insulet Corporation | 118 | $4,580 |
| Lilly USA, LLC | 43 | $3,398 |
| Sanofi-aventis U.S. LLC | 38 | $2,627 |
| BETA Bionics, Inc. | 11 | $289 |
| Xeris Pharmaceuticals, Inc. | 18 | $286 |
| Abbott | 8 | $271 |
| AstraZeneca | 8 | $260 |
| Grifols USA, LLC | 11 | $246 |
| Novo Nordisk | 12 | $232 |
| Tandem Diabetes Care, Inc. | 12 | $231 |
| Boehringer Ingelheim | 12 | $218 |
| Cequr Corporation | 2 | $160 |
| Bayer | 6 | $111 |
| Dexcom, Inc. | 5 | $90 |
| Novartis | 4 | $67 |
| Lundbeck LLC | 3 | $60 |
| Otsuka America Pharmaceutical, Inc. | 3 | $57 |
| Johnson & Johnson | 3 | $50 |
| Amgen | 3 | $43 |
| Amneal Pharmaceuticals LLC | 2 | $34 |
| Radius Health, Inc. | 2 | $32 |
| Esperion Therapeutics, Inc. | 2 | $27 |
| Lexicon Pharmaceuticals, Inc. | 2 | $25 |
| AbbVie | 1 | $23 |
| Sequel Med Tech, LLC | 1 | $22 |
| Philips North America LLC | 1 | $17 |
| IBSA Pharma Inc. | 1 | $15 |
| Idorsia Pharmaceuticals US Inc | 1 | $13 |
| Pfizer | 1 | $13 |
| Medtronic | 1 | $13 |
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.
- Omnipod$3,069
- TZIELD$1,798
- MOUNJARO$1,048
- iLet Bionic Pancreas$341
- CeQur Simplicity$136
- FREESTYLE LIBRE 3$136
- FARXIGA$125
How this compares
$13,512 in reported general payments places this provider in the 95th percentile of 391 adult health providers in Indiana.
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 |
|---|---|---|
| OzempicSemaglutide | 156 | $272,005 |
| JardianceEmpagliflozin | 107 | $128,757 |
| MounjaroTirzepatide | 73 | $121,207 |
| Omnipod 5 Dexg7g6 Pods (Gen 5)Insulin Pump Cart,auto,bt,g6/7 | 102 | $114,601 |
| Tresiba Flextouch U-200Insulin Degludec | 67 | $80,437 |
| TrulicityDulaglutide | 34 | $79,985 |
| Humalog Kwikpen U-200Insulin Lispro | 37 | $79,618 |
| Omnipod Dash Pods (Gen 4)Insulin Pump Cart,cont Inf,bt | 60 | $61,952 |
| FarxigaDapagliflozin Propanediol | 59 | $60,418 |
| Synjardy XrEmpagliflozin/Metformin Hcl | 40 | $52,025 |
| Fiasp FlextouchInsulin Aspart (Niacinamide) | 51 | $49,835 |
| Toujeo Max SolostarInsulin Glargine,hum.Rec.Anlog | 41 | $37,771 |
| Lyumjev Kwikpen U-100Insulin Lispro-Aabc | 30 | $36,201 |
| Tresiba Flextouch U-100Insulin Degludec | 58 | $36,094 |
| Toujeo SolostarInsulin Glargine,hum.Rec.Anlog | 37 | $26,029 |
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 |
|---|---|---|
| Novo NordiskOzempic, Fiasp, Novolog | $232 | $297,632194 claims |
| Lilly USA, LLCMounjaro, Trulicity, Humalog, Insulin Lispro | $3,398 | $214,107151 claims |
| Boehringer IngelheimJardiance, Synjardy Xr | $218 | $180,783147 claims |
| AstraZenecaFarxiga | $260 | $60,41859 claims |
| Sanofi-aventis U.S. LLCSoliqua 100-33 | $2,627 | $15,66613 claims |
| Amneal Pharmaceuticals LLCLevothyroxine Sodium | $34 | $70374 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 95th percentile of 391 adult health providers in Indiana.
Other adult health in Middlebury
- Jennifer BerryIndianapolis$50K
- Tajuana DavisZionsville$31K
- Patricia Damron-RobinsonMerrillville$20K
- Terry RidgeCarmel$20K
- Kristine StarcevichMerrillville$19K
- Jolyn Holliday VezaGreenfield$17K
- Anna MatulewiczMishawaka$14K
- Vincent SmithMerrillville$13K
- Lisa DankoCrown Point$13K
- Alison LaflowerIndianapolis$13K
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.