Michael Spezia, DO
Family Medicine · Saint Louis, MONPI 1316928369
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 99.0% of the total across 1,148 separate payments, which is the pattern of a clinician who attends manufacturer presentations rather than one with a consulting arrangement. It is spread thinly across 55 manufacturers, the largest accounting for just 22.5% — the pattern of someone who eats at a lot of different presentations. Among family medicine clinicians in MO with any reported payments, this total sits in the top 5% — high for the specialty, which is a reason to read the composition above rather than the number alone.
Across 1,148 payments — averaging $23.01 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- AstraZeneca$6K
- AbbVie$2K
- GSK$2K
- Novo Nordisk$2K
- Pfizer$2K
- Otsuka America Pharmaceutical, Inc.$1K
- plus $12K from 49 others
What the payments were for
- Food & beverage$26,15899%
- Education$2561%
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.
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
$26,414 in reported general payments places this provider in the 95th percentile of 2,203 family medicine providers in Missouri.
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 |
|---|---|---|
| JanuviaSitagliptin Phosphate | 155 | $164,695 |
| LinzessLinaclotide | 200 | $147,382 |
| FarxigaDapagliflozin Propanediol | 157 | $146,756 |
| OzempicSemaglutide | 111 | $143,483 |
| TrulicityDulaglutide | 119 | $141,736 |
| EliquisApixaban | 158 | $134,620 |
| MounjaroTirzepatide | 94 | $114,855 |
| JardianceEmpagliflozin | 87 | $106,610 |
| Trelegy ElliptaFluticasone/Umeclidin/Vilanter | 142 | $103,998 |
| LitfuloRitlecitinib Tosylate | 14 | $53,111 |
| Breztri AerosphereBudesonide/Glycopyr/Formoterol | 72 | $48,050 |
| MyrbetriqMirabegron | 75 | $46,615 |
| Tresiba Flextouch U-100Insulin Degludec | 61 | $44,854 |
| TradjentaLinagliptin | 36 | $28,398 |
| Lantus SolostarInsulin Glargine,hum.Rec.Anlog | 194 | $25,559 |
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 |
|---|---|---|
| Lilly USA, LLCTrulicity, Mounjaro | $1,289 | $256,591213 claims |
| AstraZenecaFarxiga, Breztri Aerosphere, Symbicort, Brilinta | $5,952 | $221,501298 claims |
| PfizerEliquis, Litfulo, Nurtec Odt | $1,528 | $200,166184 claims |
| MerckJanuvia, Janumet | $1,034 | $184,193190 claims |
| Novo NordiskOzempic, Rybelsus | $1,649 | $167,982133 claims |
| AbbVieLinzess | $2,115 | $147,382200 claims |
| Boehringer IngelheimJardiance, Tradjenta, Combivent Respimat | $329 | $144,024141 claims |
| GSKTrelegy Ellipta, Anoro Ellipta | $1,992 | $117,732166 claims |
| Astellas Pharma US IncMyrbetriq | $641 | $46,61575 claims |
| NovartisEntresto | $603 | $25,38526 claims |
| Otsuka America Pharmaceutical, Inc.Rexulti | $1,369 | $22,36315 claims |
| Sunovion Pharmaceuticals Inc.Aptiom | $213 | $19,68115 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 95th percentile of 2,203 family medicine providers in Missouri.
Other family medicine in Saint Louis
- Michael DonovanSaint Louis$78K
- Jarad SchwartzSaint Louis$36K
- Christina RobinsSaint Louis$27K
- David GlickSaint Louis$17K
- Aaron BjornSaint Louis$16K
- Paul RutledgeSaint Louis$16K
- Melissa MurraySaint Louis$15K
- Robert PozziSaint Louis$15K
- Amy MillerSaint Louis$14K
- Stephen AdamsSpringfield$636K
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.