Michel Skaf, MD
Cardiovascular Disease · Casper, WYNPI 1821041740
Payments from drug & device makers
What this record shows
The money is spread across several categories — food and beverage (50.1%), travel and lodging and education — rather than concentrated in one kind of arrangement. 28 manufacturers reported payments, led by Medtronic at 33.4% of the total. Reporting peaked in 2019 at $3,526 and has fallen 56.9% since, to $1,519 in 2025. Among cardiovascular disease clinicians in WY 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 268 payments — averaging $56.68 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Medtronic$5K
- Boston Scientific$5K
- Actelion Pharmaceuticals US, Inc.$1K
- Merck$869
- Biotronik Inc.$685
- AstraZeneca$354
- plus $2K from 22 others
Across 1 payment — averaging $58.89 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.
- Abiomed$59
What the payments were for
- Travel & lodging$7,00746%
- Food & beverage$7,60750%
- Education$5784%
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 |
|---|---|---|
| Medtronic(2 entities) | 35 | $5,069 |
| Boston Scientific | 58 | $5,057 |
| Actelion Pharmaceuticals US, Inc. | 31 | $1,164 |
| Merck | 48 | $869 |
| Biotronik Inc. | 2 | $685 |
| AstraZeneca | 18 | $354 |
| Novartis | 15 | $307 |
| Shockwave Medical, Inc | 1 | $192 |
| Amgen | 8 | $182 |
| Alnylam Pharmaceuticals Inc. | 3 | $159 |
| Abbott | 1 | $155 |
| ZOLL Services LLC (a/k/a ZOLL Lifecor Corp) | 8 | $120 |
| Impulse Dynamics (USA) Inc. | 2 | $118 |
| E.r. Squibb & Sons, L.L.C. | 7 | $107 |
| Pfizer | 7 | $103 |
| Kiniksa Pharmaceuticals, Ltd. | 5 | $97 |
| Abiomed | 2 | $89 |
| Biosense Webster, Inc. | 2 | $57 |
| Bayer | 3 | $53 |
| Boehringer Ingelheim | 3 | $51 |
| Canon Medical Systems USA, Inc. | 1 | $43 |
| Johnson & Johnson | 2 | $41 |
| Viatris Specialty LLC | 1 | $26 |
| Amarin Pharma, Inc. | 1 | $23 |
| Bardy Diagnostics, Inc. | 1 | $22 |
| Sanofi-aventis U.S. LLC | 1 | $20 |
| GE HealthCare | 1 | $15 |
| Daiichi Sankyo 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.
- Reveal LINQ$1,746
- VenaSeal$1,437
- INGEVITY$1,293
- Abre$355
- ClosureFast$292
- Micra$203
- Vascular Lithotripsy$192
- HeartMate 3 Left Ventricular Assist Device$155
- AMVUTTRA$125
- BRILINTA$112
- UPTRAVI$101
- OPSUMIT$101
- IN.PACT Admiral$100
How this compares
$15,191 in reported general payments places this provider in the 95th percentile of 22 cardiovascular disease providers in Wyoming.
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 |
|---|---|---|
| EliquisApixaban | 501 | $610,870 |
| VyndamaxTafamidis | 12 | $273,344 |
| EntrestoSacubitril/Valsartan | 107 | $103,427 |
| XareltoRivaroxaban | 80 | $98,985 |
| FarxigaDapagliflozin Propanediol | 50 | $51,271 |
| JardianceEmpagliflozin | 23 | $38,395 |
| Metoprolol Succinate | 1,202 | $16,026 |
| Sildenafil Citrate | 81 | $14,110 |
| OzempicSemaglutide | 11 | $14,084 |
| VascepaIcosapent Ethyl | 11 | $9,532 |
| Trelegy ElliptaFluticasone/Umeclidin/Vilanter | 11 | $7,240 |
| Atorvastatin Calcium | 564 | $6,749 |
| ClopidogrelClopidogrel Bisulfate | 244 | $4,238 |
| Felodipine ErFelodipine | 132 | $4,172 |
| Lisinopril | 587 | $3,919 |
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 |
|---|---|---|
| PfizerEliquis, Vyndamax | $103 | $884,214513 claims |
| NovartisEntresto | $307 | $103,427107 claims |
| Johnson & JohnsonXarelto | $41 | $98,98580 claims |
| AstraZenecaFarxiga | $354 | $51,27150 claims |
| Boehringer IngelheimJardiance | $51 | $38,39523 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 22 cardiovascular disease providers in Wyoming.
Other cardiovascular disease in Casper
- Robert NovickCasper$4K
- Adrian FlutureCasper$3K
- Allan WicksCasper$1K
- Oleg IvanovCasper$765
- John PickrellCasper$526
- David GonzalezAfton$6K
- Brian KellyPowell$4K
- Smitha NeerukondaCheyenne$3K
- Michael BrennanSheridan$3K
- William BrannEvanston$2K
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.