Michelle Downie, NP
Family · Apple Valley, CANPI 1093137689
Payments from drug & device makers
Across 34 payments — averaging $55.74 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Axonics, Inc.$1K
- Urovant Sciences Inc$170
- Astellas Pharma US Inc$140
- Therapeuticsmd, Inc.$80
- Pfizer$70
What the payments were for
- Travel & lodging$1,10358%
- Food & beverage$79042%
- Education$20%
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 |
|---|---|---|
| Axonics, Inc. | 9 | $1,435 |
| Urovant Sciences Inc | 10 | $170 |
| Astellas Pharma US Inc | 8 | $140 |
| Therapeuticsmd, Inc. | 4 | $80 |
| Pfizer | 3 | $70 |
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.
- Axonics r-SNM System$1,226
How this compares
$1,895 in reported general payments places this provider in the 80th percentile of 10,634 family 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 |
|---|---|---|
| GemtesaVibegron | 27 | $32,350 |
| MyrbetriqMirabegron | 30 | $26,885 |
| EstringEstradiol | 39 | $20,653 |
| ImvexxyEstradiol | 42 | $20,639 |
| Estradiol | 217 | $20,156 |
| PremarinEstrogens, Conjugated | 29 | $12,406 |
| YuvafemEstradiol | 17 | $3,116 |
| Methenamine Hippurate | 15 | $1,425 |
| Trospium Chloride ErTrospium Chloride | 12 | $1,298 |
| Nitrofurantoin Mono-MacroNitrofurantoin Monohyd/M-Cryst | 44 | $359 |
| Amoxicillin-Clavulanate PotassAmoxicillin/Potassium Clav | 12 | $67 |
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 |
|---|---|---|
| PfizerEstring, Premarin | $70 | $33,05968 claims |
| Astellas Pharma US IncMyrbetriq | $140 | $26,88530 claims |
| Therapeuticsmd, Inc.Imvexxy | $80 | $20,63942 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 80th percentile of 10,634 family providers in California.
Other family in Apple Valley
- Lori RobertsonChino Hills$475K
- Annette ShonLos Angeles$406K
- Nancy GardettoSan Diego$394K
- Lisa HigginsHanford$311K
- Jennifer TougasBakersfield$302K
- Kim SchaferSacramento$288K
- Dawn MeyerSan Diego$270K
- Jennifer KangCerritos$255K
- Jenine StoneEscondido$231K
- Erin DwyerSan Diego$189K
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.