RxDoctor Payments Data

Manuel Fernandez Palmer, MD

Nephrology · Waco, TXNPI 1407136310

Payments from drug & device makers

$1,249in general payments, 2019–2025

Across 36 payments — averaging $34.68 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.

  • Nxstage Medical, Inc.$367
  • AstraZeneca$270
  • Fresenius USA Marketing, Inc.$193
  • Otsuka America Pharmaceutical, Inc.$162
  • Aurinia Pharma U.S., Inc.$131
  • Akebia Therapeutics Inc$36
  • plus $89 from 4 others

What the payments were for

  • Food & beverage$1,22998%
  • Education$202%

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

19
20
21
23
24
25

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.

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

$1,249 in reported general payments places this provider in the 40th percentile of 1,070 nephrology providers in Texas.

See all nephrology providers in Texas

Medicare billing

Part B allowed, 2024
$171,569
Medicare patients
447
Services billed
1,403

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

DrugClaimsCost to plans & patients
AuryxiaFerric Citrate19$38,510
JardianceEmpagliflozin50$36,215
Sevelamer Carbonate124$31,983
VeltassaPatiromer Calcium Sorbitex19$24,708
FarxigaDapagliflozin Propanediol29$20,193
LokelmaSodium Zirconium Cyclosilicate20$14,260
Midodrine Hcl50$2,791
Torsemide100$2,083
Calcitriol176$2,032
Carvedilol143$2,018
Doxazosin Mesylate170$1,667
Calcium Acetate19$1,426
Cinacalcet Hcl14$890
Losartan Potassium99$754
Potassium Citrate ErPotassium Citrate21$647

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.

CompanyPaid to this providerPart D cost of their drugs
Akebia Therapeutics IncAuryxia$36$38,51019 claims
AstraZenecaFarxiga, Lokelma$270$34,45349 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 40th percentile of 1,070 nephrology providers in Texas.

Other nephrology in Waco

See the full list for Texas

Where these figures come from

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