Melanie Gramling, APRN
Adult Health · Fort Smith, ARNPI 1194024158
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 100.0% of the total across 70 separate payments, which is the pattern of a clinician who attends manufacturer presentations rather than one with a consulting arrangement. 17 manufacturers reported payments, led by Novartis at 30.8% of the total.
Across 70 payments — averaging $16.61 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Novartis$358
- ZOLL Services LLC (a/k/a ZOLL Lifecor Corp)$172
- AstraZeneca$127
- Medtronic$80
- Philips North America LLC$60
- Merck$50
- plus $316 from 11 others
What the payments were for
- Food & beverage$1,163100%
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 |
|---|---|---|
| Novartis | 23 | $358 |
| ZOLL Services LLC (a/k/a ZOLL Lifecor Corp) | 9 | $172 |
| AstraZeneca | 9 | $127 |
| Medtronic | 5 | $80 |
| Philips North America LLC | 4 | $60 |
| Merck | 3 | $50 |
| Boehringer Ingelheim | 3 | $48 |
| Johnson & Johnson | 3 | $46 |
| Kestra Medical Technology Services, Inc. | 1 | $42 |
| Amgen | 3 | $37 |
| Boston Scientific | 1 | $26 |
| Amarin Pharma, Inc. | 1 | $24 |
| Abbott | 1 | $24 |
| Edwards Lifesciences | 1 | $20 |
| Pfizer | 1 | $18 |
| Sanofi-aventis U.S. LLC | 1 | $18 |
| E.r. Squibb & Sons, L.L.C. | 1 | $14 |
How this compares
$1,163 in reported general payments places this provider in the 65th percentile of 154 adult health providers in Arkansas.
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 |
|---|---|---|
| EliquisApixaban | 331 | $297,075 |
| EntrestoSacubitril/Valsartan | 145 | $147,716 |
| Repatha SureclickEvolocumab | 100 | $72,511 |
| XareltoRivaroxaban | 60 | $63,311 |
| FarxigaDapagliflozin Propanediol | 38 | $34,261 |
| JardianceEmpagliflozin | 27 | $30,467 |
| BrilintaTicagrelor | 40 | $24,151 |
| Metoprolol Succinate | 653 | $8,797 |
| Repatha SyringeEvolocumab | 15 | $6,081 |
| Ranolazine ErRanolazine | 61 | $5,119 |
| Atorvastatin Calcium | 678 | $5,115 |
| Flecainide Acetate | 59 | $4,079 |
| ClopidogrelClopidogrel Bisulfate | 487 | $3,581 |
| Prasugrel Hcl | 30 | $2,870 |
| Ezetimibe | 84 | $2,848 |
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 |
|---|---|---|
| PfizerEliquis | $18 | $297,075331 claims |
| NovartisEntresto | $358 | $147,716145 claims |
| Johnson & JohnsonXarelto | $46 | $63,31160 claims |
| AstraZenecaFarxiga, Brilinta | $127 | $58,41278 claims |
| Boehringer IngelheimJardiance | $48 | $30,46727 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 65th percentile of 154 adult health providers in Arkansas.
Other adult health in Fort Smith
- Gina NullFort Smith$8K
- Connie WardFort Smith$5K
- Mandy FluittFort Smith$4K
- Chasidy McAllisterFort Smith$3K
- Courtney GueyeFort Smith$2K
- Elizabeth CharlesFort Smith$2K
- Ann HarpFort Smith$2K
- Paula BrosnanFort Smith$1K
- Holly MooreLittle Rock$59K
- Deborah ShipmanJonesboro$41K
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.