Merhala Balasubramaniam, MD
Pulmonary Disease · Great Falls, MTNPI 1629450333
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 100.0% of the total across 35 separate payments, which is the pattern of a clinician who attends manufacturer presentations rather than one with a consulting arrangement. 11 manufacturers reported payments, led by GSK at 30.9% of the total. 2024 is the largest year on record at $445, 3.2 times the $138 reported in 2019.
Across 35 payments — averaging $28.98 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- GSK$314
- Amgen$154
- Actelion Pharmaceuticals US, Inc.$142
- AstraZeneca$138
- Genentech USA, Inc.$138
- Pulmonx Corporation$42
- plus $87 from 5 others
What the payments were for
- Food & beverage$1,014100%
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 |
|---|---|---|
| GSK | 18 | $314 |
| Amgen | 1 | $154 |
| Actelion Pharmaceuticals US, Inc. | 5 | $142 |
| AstraZeneca | 4 | $138 |
| Genentech USA, Inc. | 1 | $138 |
| Pulmonx Corporation | 1 | $42 |
| Merck | 1 | $25 |
| Grifols USA, LLC | 1 | $17 |
| Boehringer Ingelheim | 1 | $16 |
| Regeneron Healthcare Solutions, Inc. | 1 | $15 |
| Insmed, Inc. | 1 | $14 |
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.
- Tavneos$154
How this compares
$1,014 in reported general payments places this provider in the 65th percentile of 43 pulmonary disease providers in Montana.
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 |
|---|---|---|
| OfevNintedanib Esylate | 12 | $150,760 |
| Trelegy ElliptaFluticasone/Umeclidin/Vilanter | 85 | $76,389 |
| Breztri AerosphereBudesonide/Glycopyr/Formoterol | 55 | $55,833 |
| NucalaMepolizumab | 13 | $45,078 |
| Spiriva RespimatTiotropium Bromide | 56 | $36,960 |
| Stiolto RespimatTiotropium Br/Olodaterol Hcl | 62 | $36,858 |
| XolairOmalizumab | 12 | $31,245 |
| Spiriva HandihalerTiotropium Bromide | 52 | $28,064 |
| SymbicortBudesonide/Formoterol Fumarate | 80 | $20,797 |
| Incruse ElliptaUmeclidinium Bromide | 57 | $20,379 |
| Anoro ElliptaUmeclidinium Brm/Vilanterol Tr | 33 | $19,397 |
| Fluticasone-SalmeterolFluticasone Propion/Salmeterol | 63 | $10,271 |
| Advair HfaFluticasone Propion/Salmeterol | 22 | $10,115 |
| Bevespi AerosphereGlycopyrrolate/Formoterol Fum | 23 | $9,127 |
| DuleraMometasone/Formoterol | 26 | $8,992 |
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 IngelheimOfev, Spiriva Respimat, Stiolto Respimat | $16 | $224,578130 claims |
| GSKTrelegy Ellipta, Nucala, Incruse Ellipta, Anoro Ellipta, Breo Ellipta | $314 | $174,337223 claims |
| AstraZenecaBreztri Aerosphere, Symbicort, Bevespi Aerosphere | $138 | $85,757158 claims |
| MerckDulera | $25 | $8,99226 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 43 pulmonary disease providers in Montana.
Other pulmonary disease in Great Falls
- Megan SiskGreat Falls$20K
- John MazurGreat Falls$18K
- Gabor VarjuGreat Falls$10K
- Robert GrasseschiGreat Falls$458
- Sheela AhmedGreat Falls$158
- Sean DowGreat Falls$20
- Richard KearleyGreat Falls$16
- William KrauseGreat Falls$0
- Gregory LemenseBozeman$39K
- Bethany WeilerKalispell$14K
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.