Melissa Smallfield, MD
Advanced Heart Failure and Transplant Cardiology · Richmond, VANPI 1043394240
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 91.4% of the total across 50 separate payments, which is the pattern of a clinician who attends manufacturer presentations rather than one with a consulting arrangement. 14 manufacturers reported payments, led by Abbott at 54.9% of the total. Reporting peaked in 2022 at $1,771 and has fallen 75.8% since, to $429 in 2025. That places this record below the midpoint for advanced heart failure and transplant cardiology clinicians in VA, where the typical reported total is $4,498.
Across 50 payments — averaging $95.71 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Abbott$3K
- Medtronic$1K
- Abiomed$263
- Alnylam Pharmaceuticals Inc.$150
- Boston Scientific$138
- AstraZeneca$129
- plus $340 from 8 others
Across 31 payments — averaging $2138.68 each. Payments tied to a research study. These frequently flow through the physician to a hospital or research institution rather than to the physician personally.
- United Therapeutics Corporation$53K
- Actelion Pharmaceuticals, Ltd$13K
- Carmat$360
What the payments were for
- Travel & lodging$4119%
- Food & beverage$4,37491%
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 |
|---|---|---|
| Abbott | 24 | $2,628 |
| Medtronic(2 entities) | 10 | $1,137 |
| Abiomed | 2 | $263 |
| Alnylam Pharmaceuticals Inc. | 2 | $150 |
| Boston Scientific | 1 | $138 |
| AstraZeneca | 2 | $129 |
| Bayer | 2 | $82 |
| Sanofi | 1 | $65 |
| Merck | 1 | $62 |
| United Therapeutics Corporation | 1 | $46 |
| Procyrion, Inc. | 1 | $27 |
| Cvrx, Inc. | 1 | $25 |
| Boehringer Ingelheim | 1 | $17 |
| Livanova USA, Inc. | 1 | $15 |
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.
- THORATEC HEARTMATE 3 LVAS IMPLANT KIT$1,096
- HeartWare HVAD$468
- CARDIOMEMS$369
- HeartMate$289
- HeartMate 3 Left Ventricular Assist Device$185
- Mitra Clip system$149
- Impella$127
- HVAD PUMP IMPLANT KIT$125
How this compares
$4,785 in reported general payments places this provider in the 50th percentile of 43 advanced heart failure and transplant cardiology providers in Virginia.
See all advanced heart failure and transplant cardiology providers in Virginia →
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 |
|---|---|---|
| EntrestoSacubitril/Valsartan | 222 | $256,643 |
| JardianceEmpagliflozin | 115 | $127,961 |
| EliquisApixaban | 66 | $86,083 |
| FarxigaDapagliflozin Propanediol | 35 | $37,156 |
| Sildenafil Citrate | 14 | $6,631 |
| Torsemide | 108 | $3,541 |
| Tacrolimus | 32 | $2,906 |
| Potassium Chloride | 59 | $2,597 |
| Dexlansoprazole DrDexlansoprazole | 12 | $2,425 |
| Eplerenone | 26 | $1,628 |
| Mycophenolate Mofetil | 22 | $1,594 |
| Bumetanide | 33 | $1,479 |
| Metoprolol Succinate | 92 | $1,022 |
| Spironolactone | 152 | $840 |
| Pantoprazole Sodium | 82 | $717 |
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 |
|---|---|---|
| Boehringer IngelheimJardiance | $17 | $127,961115 claims |
| AstraZenecaFarxiga | $129 | $37,15635 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 50th percentile of 43 advanced heart failure and transplant cardiology providers in Virginia.
Other advanced heart failure and transplant cardiology in Richmond
- Edward SaweyRichmond$35K
- Lavone SmithRichmond$23K
- Neil LewisRichmond$9K
- Pengyang LiRichmond$4K
- Inna TchoukinaRichmond$3K
- Nimesh PatelRichmond$2K
- Kelli FoxRichmond$2K
- Krishnasree RaoRichmond$605
- Anit MankadRichmond$425
- Sasa MitrovicRichmond$139
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.