Mikhail Alper, PA
Physician Assistant · Madera, CANPI 1588698112
Payments from drug & device makers
What this record shows
This record is dominated by speaking fees: $674,139 of the $888,933 with a category attached, or 75.8%. It is spread thinly across 43 manufacturers, the largest accounting for just 23.4%. 2025 is the largest year on record at $286,377, 6.9 times the $41,235 reported in 2021. Among physician assistant clinicians in CA 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 2,986 payments — averaging $297.70 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- AbbVie$208K
- Johnson & Johnson$193K
- Regeneron Healthcare Solutions, Inc.$79K
- Lilly USA, LLC$59K
- Intercept Pharmaceuticals, Inc.$49K
- Aimmune Therapeutics, Inc.$49K
- plus $253K from 37 others
What the payments were for
- Consulting fees$63,5247%
- Speaking & faculty fees$674,13976%
- Travel & lodging$90,97810%
- Food & beverage$60,1377%
- Education$1550%
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
$888,933 in reported general payments places this provider in the 95th 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 |
|---|---|---|
| ZenpepLipase/Protease/Amylase | 130 | $701,638 |
| StelaraUstekinumab | 29 | $689,893 |
| XifaxanRifaximin | 96 | $328,697 |
| CreonLipase/Protease/Amylase | 103 | $313,204 |
| LinzessLinaclotide | 158 | $170,509 |
| LivdelziSeladelpar Lysine | 12 | $154,343 |
| IqirvoElafibranor | 13 | $146,004 |
| RinvoqUpadacitinib | 20 | $131,596 |
| OcalivaObeticholic Acid | 14 | $115,216 |
| RemicadeInfliximab | 18 | $88,274 |
| RezdiffraResmetirom | 15 | $58,328 |
| VemlidyTenofovir Alafenamide | 36 | $52,483 |
| IbsrelaTenapanor Hcl | 24 | $42,188 |
| VoqueznaVonoprazan Fumarate | 54 | $36,260 |
| Ursodiol | 140 | $28,368 |
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 |
|---|---|---|
| Johnson & JohnsonStelara, Remicade | $192,954 | $778,16747 claims |
| Aimmune Therapeutics, Inc.Zenpep | $48,505 | $701,638130 claims |
| AbbVieCreon, Linzess, Rinvoq | $207,658 | $615,308281 claims |
| Salix Pharmaceuticals, A Division Of Bausch Health US, LLCXifaxan | $16,008 | $328,69796 claims |
| GileadLivdelzi, Vemlidy | $34,594 | $206,82648 claims |
| Ipsen Biopharmaceuticals, IncIqirvo | $17,525 | $146,00413 claims |
| Intercept Pharmaceuticals, Inc.Ocaliva | $48,752 | $115,21614 claims |
| Madrigal PharmaceuticalsRezdiffra | $36,051 | $58,32815 claims |
| Ardelyx, Inc.Ibsrela | $6,002 | $42,18824 claims |
| Phathom Pharmaceuticals, Inc.Voquezna | $22,097 | $36,26054 claims |
| Braintree Laboratories, Inc.Sutab | $63 | $1,75211 claims |
| Fresenius Kabi USA, LLCSodium Chloride | $42 | $5122 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 10,423 physician assistant providers in California.
Other physician assistant in Madera
- Andrea NguyenIrvine$1M
- Erin JensenUpland$716K
- Franklin ClineSacramento$458K
- Carla CrespoMarina del Rey$297K
- Katherine OsakiEl Centro$274K
- Shawna JonesFountain Valley$266K
- Heather AustinSalinas$219K
- Andrea FoxStanford$172K
- Asma HussainiThousand Oaks$102K
- Michael FloresLynwood$97K
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.