RxDoctor Payments Data

Marcel Twahirwa, MD

Endocrinology, Diabetes & Metabolism · Mission, TXNPI 1841381167

Payments from drug & device makers

$184,334in general payments, 2019–2025

Across 190 payments — averaging $970.18 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.

  • Astrazeneca UK Limited$70K
  • Novo Nordisk$27K
  • AstraZeneca$21K
  • Kowa Research Institute, Inc.$20K
  • Boehringer Ingelheim$15K
  • Lilly USA, LLC$11K
  • plus $21K from 10 others

What the payments were for

  • Consulting fees$2,9254%
  • Speaking & faculty fees$70,94588%
  • Travel & lodging$3,5914%
  • Food & beverage$3,4294%
  • Education$140%
  • Gifts$590%

General payments by program year

19
20
21
22
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

$184,334 in reported general payments places this provider in the 85th percentile of 658 endocrinology, diabetes & metabolism providers in Texas.

See all endocrinology, diabetes & metabolism providers in Texas

Medicare billing

Part B allowed, 2024
$58,423
Medicare patients
283
Services billed
649

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
OzempicSemaglutide1,173$1,650,445
JardianceEmpagliflozin603$735,404
TrulicityDulaglutide313$552,520
FarxigaDapagliflozin Propanediol403$415,985
SynjardyEmpagliflozin/Metformin Hcl246$311,027
Tresiba Flextouch U-100Insulin Degludec421$285,174
MounjaroTirzepatide178$266,982
Tresiba Flextouch U-200Insulin Degludec185$188,946
Humulin R U-500 KwikpenInsulin Regular, Human106$146,169
Xigduo XrDapaglifloz Propaned/Metformin126$138,993
Bydureon BciseExenatide Microspheres83$124,156
Synjardy XrEmpagliflozin/Metformin Hcl110$116,507
Toujeo SolostarInsulin Glargine,hum.Rec.Anlog117$96,235
RybelsusSemaglutide40$82,837
JanuviaSitagliptin Phosphate67$71,458

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
Novo NordiskOzempic, Rybelsus, Fiasp$27,228$1,744,7501,226 claims
Boehringer IngelheimJardiance, Synjardy, Synjardy Xr, Tradjenta, Trijardy Xr$14,662$1,254,8591,057 claims
Lilly USA, LLCTrulicity, Mounjaro$10,851$819,501491 claims
AstraZenecaFarxiga$21,246$415,985403 claims
MerckJanuvia, Janumet$4,485$97,04193 claims
Mannkind CorporationAfrezza$2,867$28,93012 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 85th percentile of 658 endocrinology, diabetes & metabolism providers in Texas.

Other endocrinology, diabetes & metabolism in Mission

See the full list for Texas

Where these figures come from

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