Meral El Ramahi, MD
Rheumatology · Nashville, TNNPI 1811317746
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 94.7% of the total across 91 separate payments, which is the pattern of a clinician who attends manufacturer presentations rather than one with a consulting arrangement. 12 manufacturers reported payments, led by AbbVie at 24.1% of the total. 2025 is the largest year on record at $1,057, 3.0 times the $356 reported in 2022. That places this record below the midpoint for rheumatology clinicians in TN, where the typical reported total is $5,288.
Across 91 payments — averaging $20.64 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- AbbVie$452
- Amgen$303
- Johnson & Johnson$278
- Novartis$167
- AstraZeneca$129
- E.r. Squibb & Sons, L.L.C.$121
- plus $429 from 6 others
What the payments were for
- Food & beverage$1,77995%
- Education$1005%
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 |
|---|---|---|
| AbbVie | 24 | $452 |
| Amgen | 18 | $303 |
| Johnson & Johnson | 10 | $278 |
| Novartis | 8 | $167 |
| AstraZeneca(2 entities) | 6 | $129 |
| E.r. Squibb & Sons, L.L.C. | 5 | $121 |
| UCB, Inc. | 5 | $109 |
| GSK | 5 | $102 |
| Lilly USA, LLC | 4 | $77 |
| Pfizer | 3 | $67 |
| Genentech USA, Inc. | 2 | $50 |
| Ultragenyx Pharmaceutical Inc. | 1 | $23 |
How this compares
$1,879 in reported general payments places this provider in the 35th percentile of 127 rheumatology providers in Tennessee.
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 |
|---|---|---|
| Mycophenolate Mofetil | 26 | $2,091 |
| Hydroxychloroquine Sulfate | 60 | $943 |
| MethotrexateMethotrexate Sodium | 38 | $759 |
| Prednisone | 79 | $342 |
| Colchicine | 13 | $294 |
| Sulfasalazine | 15 | $194 |
| Famotidine | 19 | $175 |
| Gabapentin | 14 | $95 |
| Mirtazapine | 12 | $76 |
Paid to pharmacies, not to this prescriber.
Other rheumatology in Nashville
- Victor ByrdNashville$247K
- Christian RheaNashville$81K
- Tyler ReeseNashville$80K
- John BooneNashville$70K
- Simpson TannerNashville$53K
- Narender AnnapureddyNashville$29K
- Erin WilfongNashville$18K
- Robert LagroneNashville$17K
- Poonam SomaiNashville$14K
- Susan HarwellNashville$10K
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.