Mireille Touma
Primary Care · Livonia, MINPI 1972934941
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 99.4% of the total across 32 separate payments, which is the pattern of a clinician who attends manufacturer presentations rather than one with a consulting arrangement. 10 manufacturers reported payments, led by Lilly USA, LLC at 33.8% of the total. 2025 is the largest year on record at $869, more than ten times the $59 reported in 2021.
Across 32 payments — averaging $62.35 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Lilly USA, LLC$675
- Boehringer Ingelheim$435
- Salix Pharmaceuticals, A Division Of Bausch Health US, LLC$140
- AstraZeneca$138
- Novo Nordisk$125
- Exact Sciences$125
- plus $359 from 4 others
What the payments were for
- Food & beverage$1,98499%
- Education$121%
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 |
|---|---|---|
| Lilly USA, LLC | 9 | $675 |
| Boehringer Ingelheim | 10 | $435 |
| Salix Pharmaceuticals, A Division Of Bausch Health US, LLC | 3 | $140 |
| AstraZeneca | 2 | $138 |
| Novo Nordisk | 1 | $125 |
| Exact Sciences | 1 | $125 |
| Phathom Pharmaceuticals, Inc. | 1 | $125 |
| Agios Pharmaceuticals, Inc. | 1 | $104 |
| Johnson & Johnson | 1 | $83 |
| Shield Therapeutics Inc | 3 | $47 |
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
$1,995 in reported general payments places this provider in the 80th percentile of 292 primary care providers in Michigan.
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 |
|---|---|---|
| JardianceEmpagliflozin | 74 | $65,594 |
| JanuviaSitagliptin Phosphate | 40 | $33,536 |
| TrulicityDulaglutide | 17 | $23,495 |
| Trelegy ElliptaFluticasone/Umeclidin/Vilanter | 25 | $17,225 |
| EliquisApixaban | 20 | $12,579 |
| JanumetSitagliptin Phos/Metformin Hcl | 12 | $6,740 |
| LinzessLinaclotide | 12 | $6,290 |
| Basaglar Kwikpen U-100Insulin Glargine,hum.Rec.Anlog | 13 | $4,895 |
| Fluticasone-SalmeterolFluticasone Propion/Salmeterol | 26 | $4,130 |
| Lantus SolostarInsulin Glargine,hum.Rec.Anlog | 23 | $2,757 |
| Novolog FlexpenInsulin Aspart | 12 | $2,499 |
| Albuterol Sulfate HfaAlbuterol Sulfate | 44 | $1,375 |
| Atorvastatin Calcium | 186 | $1,253 |
| Diclofenac Sodium | 49 | $1,176 |
| Esomeprazole Magnesium | 11 | $884 |
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 |
|---|---|---|
| Boehringer IngelheimJardiance | $435 | $65,59474 claims |
| Lilly USA, LLCTrulicity | $675 | $23,49517 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 292 primary care providers in Michigan.
Other primary care in Livonia
- Sarah VanceLivonia$5K
- Jessica NarrettLivonia$3K
- Donna HamillGrosse Pointe$17K
- Marie Sighe-NzokouLansing$16K
- Alexandria SchwabBay City$10K
- Amy HenryRochester Hills$10K
- Claire GebaraWaterford$9K
- Vanita RobinsonDetroit$9K
- Mary BoudreauMason$9K
- Kimberly FrazierLansing$8K
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.