Michele Carbonell-Smith, APRN
Nurse Practitioner · Paducah, KYNPI 1447557160
Payments from drug & device makers
Across 637 payments — averaging $20.86 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- AstraZeneca$3K
- GSK$2K
- Boehringer Ingelheim$1K
- Insmed, Inc.$779
- Regeneron Healthcare Solutions, Inc.$636
- Sanofi$589
- plus $5K from 29 others
What the payments were for
- Food & beverage$13,10799%
- Education$1831%
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 |
|---|---|---|
| AstraZeneca | 88 | $3,001 |
| GSK | 121 | $1,743 |
| Boehringer Ingelheim | 62 | $1,350 |
| Insmed, Inc. | 41 | $779 |
| Regeneron Healthcare Solutions, Inc. | 34 | $636 |
| Sanofi | 34 | $589 |
| Actelion Pharmaceuticals US, Inc. | 25 | $556 |
| Electromed, Inc. | 25 | $512 |
| Grifols USA, LLC | 30 | $465 |
| United Therapeutics Corporation | 21 | $439 |
| Amgen | 21 | $432 |
| Mallinckrodt Hospital Products Inc. | 9 | $316 |
| Takeda Pharmaceuticals U.S.A., Inc. | 14 | $309 |
| Mylan Specialty L.p. | 19 | $296 |
| Verona Pharma, Inc. | 16 | $246 |
| Viatris Specialty LLC | 12 | $204 |
| Pulmonx Corporation | 7 | $188 |
| Merck | 10 | $179 |
| Philips North America LLC | 9 | $139 |
| Inspire Medical Systems, Inc. | 2 | $133 |
| Genentech USA, Inc. | 7 | $114 |
| Axsome Therapeutics, Inc. | 1 | $106 |
| Baxter Healthcare | 5 | $99 |
| AbbVie | 5 | $66 |
| Teva Pharmaceuticals USA, Inc. | 4 | $64 |
| Jazz Pharmaceuticals Inc. | 3 | $62 |
| Vifor Pharma, Inc. | 3 | $58 |
| Lilly USA, LLC | 2 | $45 |
| Novo Nordisk | 1 | $39 |
| Mayne Pharma Commercial LLC | 1 | $33 |
| Ambu Inc. | 1 | $25 |
| Novartis | 1 | $18 |
| Bayer | 1 | $17 |
| Phadia US Inc. | 1 | $15 |
| Liquidia Technologies, 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.
How this compares
$13,290 in reported general payments places this provider in the 95th percentile of 1,918 nurse practitioner providers in Kentucky.
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 |
|---|---|---|
| Trelegy ElliptaFluticasone/Umeclidin/Vilanter | 315 | $250,502 |
| Breztri AerosphereBudesonide/Glycopyr/Formoterol | 140 | $123,029 |
| TezspireTezepelumab-Ekko | 23 | $97,931 |
| Stiolto RespimatTiotropium Br/Olodaterol Hcl | 131 | $72,912 |
| Spiriva RespimatTiotropium Bromide | 83 | $64,543 |
| AirsupraAlbuterol Sulfate/Budesonide | 48 | $32,017 |
| Arnuity ElliptaFluticasone Furoate | 77 | $26,359 |
| Breo ElliptaFluticasone/Vilanterol | 48 | $25,483 |
| SymbicortBudesonide/Formoterol Fumarate | 46 | $16,739 |
| Combivent RespimatIpratropium/Albuterol Sulfate | 29 | $15,736 |
| Anoro ElliptaUmeclidinium Brm/Vilanterol Tr | 31 | $14,252 |
| Atrovent HfaIpratropium Bromide | 24 | $12,931 |
| Albuterol Sulfate HfaAlbuterol Sulfate | 299 | $10,179 |
| Ventolin HfaAlbuterol Sulfate | 88 | $6,269 |
| Advair HfaFluticasone Propion/Salmeterol | 13 | $5,088 |
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 |
|---|---|---|
| GSKTrelegy Ellipta, Arnuity Ellipta, Breo Ellipta, Anoro Ellipta | $1,743 | $316,597471 claims |
| AstraZenecaBreztri Aerosphere, Tezspire, Airsupra, Symbicort | $3,001 | $269,716257 claims |
| Boehringer IngelheimStiolto Respimat, Spiriva Respimat, Combivent Respimat | $1,350 | $153,192243 claims |
| Teva Pharmaceuticals USA, Inc.Qvar Redihaler | $64 | $4,96911 claims |
| MerckDulera | $179 | $3,93712 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 1,918 nurse practitioner providers in Kentucky.
Other nurse practitioner in Paducah
- Leon KehrerPaducah$11K
- Aaron GarrettPaducah$10K
- Kaci MedleyPaducah$10K
- Rachael BradfordLexington$447K
- Tara MuddLouisville$243K
- Lee HaasLouisville$95K
- Ashley KnableLouisville$86K
- Christina BenningerLouisville$81K
- Courtney BowlingCampbellsville$47K
- Rebecca BraunerLouisville$40K
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.