Michal Twardowski, PA
Physician Assistant · Costa Mesa, CANPI 1235753856
Payments from drug & device makers
Across 165 payments — averaging $21.02 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Alkermes, Inc.$539
- AbbVie$504
- Sunovion Pharmaceuticals Inc.$486
- Johnson & Johnson$460
- Lundbeck LLC$260
- Otsuka America Pharmaceutical, Inc.$259
- plus $960 from 10 others
What the payments were for
- Food & beverage$3,42299%
- Education$471%
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 |
|---|---|---|
| Alkermes, Inc. | 13 | $539 |
| AbbVie | 21 | $504 |
| Sunovion Pharmaceuticals Inc. | 31 | $486 |
| Johnson & Johnson | 16 | $460 |
| Lundbeck LLC | 11 | $260 |
| Otsuka America Pharmaceutical, Inc. | 15 | $259 |
| Takeda Pharmaceuticals U.S.A., Inc. | 13 | $243 |
| Livanova USA, Inc. | 10 | $236 |
| ITI, Inc. (d/b/a Intra-cellular Therapies, Inc.) | 12 | $173 |
| Neurocrine Biosciences, Inc. | 3 | $158 |
| Noven Therapeutics, LLC | 2 | $43 |
| Eisai Inc. | 2 | $32 |
| Corium, LLC | 13 | $20 |
| Avanir Pharmaceuticals, Inc. | 1 | $20 |
| Bausch Health US, LLC | 1 | $18 |
| Supernus Pharmaceuticals, Inc. | 1 | $16 |
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.
- LYBALVI$894
- ARISTADA$472
- INVEGA SUSTENNA$125
- VRAYLAR$125
- ARISTADA INITIO$118
- INGREZZA$116
How this compares
$3,468 in reported general payments places this provider in the 85th percentile of 10,423 physician assistant providers in California.
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 |
|---|---|---|
| Dexmethylphenidate Hcl ErDexmethylphenidate Hcl | 13 | $2,322 |
| Sertraline Hcl | 27 | $1,842 |
| Dextroamphetamine-Amphet ErDextroamphetamine/Amphetamine | 29 | $1,055 |
| Escitalopram Oxalate | 62 | $720 |
| Bupropion XlBupropion Hcl | 35 | $639 |
| Oxcarbazepine | 15 | $587 |
| Venlafaxine Hcl ErVenlafaxine Hcl | 23 | $539 |
| Lamotrigine | 25 | $463 |
| Fluoxetine Hcl | 18 | $458 |
| Trazodone Hcl | 45 | $397 |
| Dextroamphetamine-AmphetamineDextroamphetamine/Amphetamine | 15 | $364 |
| Quetiapine Fumarate | 12 | $333 |
| Buspirone Hcl | 22 | $238 |
| Bupropion Hcl SrBupropion Hcl | 15 | $189 |
| Gabapentin | 17 | $184 |
Paid to pharmacies, not to this prescriber.
Other physician assistant in Costa Mesa
- Alexander MuleCosta Mesa$29K
- John QuigleyDowney$2.9M
- Andrea NguyenIrvine$1M
- Mikhail AlperMadera$889K
- Erin JensenUpland$716K
- Franklin ClineSacramento$458K
- Carla CrespoMarina del Rey$297K
- Katherine OsakiEl Centro$274K
- Shawna JonesFountain Valley$266K
- Heather AustinSalinas$219K
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.