Mirian Langer
Gerontology · Daytona Beach, FLNPI 1174975908
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 100.0% of the total across 403 separate payments, which is the pattern of a clinician who attends manufacturer presentations rather than one with a consulting arrangement. It is spread thinly across 38 manufacturers, the largest accounting for just 17.9% — the pattern of someone who eats at a lot of different presentations. Among gerontology clinicians in FL with any reported payments, this total sits in the top 10% — high for the specialty, which is a reason to read the composition above rather than the number alone.
Across 403 payments — averaging $15.63 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- GSK$1K
- Novo Nordisk$959
- AbbVie$683
- Amgen$457
- Lilly USA, LLC$404
- Bayer$283
- plus $2K from 32 others
What the payments were for
- Food & beverage$6,298100%
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 |
|---|---|---|
| GSK | 87 | $1,126 |
| Novo Nordisk | 77 | $959 |
| AbbVie | 46 | $683 |
| Amgen | 24 | $457 |
| Lilly USA, LLC | 23 | $404 |
| Bayer | 14 | $283 |
| Abbott | 18 | $219 |
| Boehringer Ingelheim | 11 | $182 |
| Merck | 10 | $166 |
| Otsuka America Pharmaceutical, Inc. | 7 | $165 |
| Exact Sciences | 6 | $157 |
| Johnson & Johnson | 8 | $147 |
| Pfizer | 9 | $140 |
| Daiichi Sankyo Inc. | 5 | $108 |
| Sanofi-aventis U.S. LLC | 5 | $104 |
| Novartis | 6 | $98 |
| AstraZeneca | 5 | $89 |
| Astellas Pharma US Inc | 4 | $86 |
| Amarin Pharma, Inc. | 4 | $69 |
| Phathom Pharmaceuticals, Inc. | 3 | $66 |
| Protega Pharmaceutials Inc | 1 | $56 |
| Jazz Pharmaceuticals Inc. | 3 | $53 |
| Kowa Pharmaceuticals America, Inc. | 3 | $48 |
| Mylan Specialty L.p. | 2 | $48 |
| Almatica Pharma LLC | 3 | $45 |
| Photonicare Inc | 2 | $43 |
| Pulmonx Corporation | 2 | $41 |
| Arbor Pharmaceuticals, Inc. | 3 | $38 |
| Agios Pharmaceuticals, Inc. | 2 | $37 |
| Medtronic | 2 | $30 |
| Viatris Specialty LLC | 1 | $26 |
| ARS Pharmaceuticals Operations, Inc. | 1 | $21 |
| Biohaven Pharmaceuticals, Inc. | 1 | $19 |
| Corcept Therapeutics | 1 | $19 |
| Dexcom, Inc. | 1 | $18 |
| Ultragenyx Pharmaceutical Inc. | 1 | $17 |
| Inspire Medical Systems, Inc. | 1 | $17 |
| IBSA Pharma Inc. | 1 | $16 |
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
$6,298 in reported general payments places this provider in the 90th percentile of 714 gerontology providers in Florida.
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 | 50 | $46,848 |
| JardianceEmpagliflozin | 26 | $43,190 |
| OzempicSemaglutide | 33 | $40,117 |
| MounjaroTirzepatide | 31 | $36,300 |
| MyrbetriqMirabegron | 27 | $28,230 |
| Albuterol Sulfate HfaAlbuterol Sulfate | 105 | $4,069 |
| Lantus SolostarInsulin Glargine,hum.Rec.Anlog | 21 | $2,161 |
| SynthroidLevothyroxine Sodium | 26 | $2,127 |
| Omeprazole | 93 | $1,986 |
| Rosuvastatin Calcium | 167 | $1,691 |
| Potassium Chloride | 40 | $1,475 |
| Atorvastatin Calcium | 124 | $1,314 |
| Aripiprazole | 36 | $1,260 |
| Bupropion XlBupropion Hcl | 38 | $1,212 |
| Levothyroxine Sodium | 128 | $1,211 |
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 | $140 | $46,84850 claims |
| Boehringer IngelheimJardiance | $182 | $43,19026 claims |
| Novo NordiskOzempic | $959 | $40,11733 claims |
| Lilly USA, LLCMounjaro | $404 | $36,30031 claims |
| Astellas Pharma US IncMyrbetriq | $86 | $28,23027 claims |
| AbbVieSynthroid | $683 | $2,12726 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 90th percentile of 714 gerontology providers in Florida.
Other gerontology in Daytona Beach
- Flavius NascimentoCoral Springs$226K
- Michelle HartogWinter Park$90K
- Alejandra Rosales-CohenOrange City$88K
- Jennifer PacilettiAtlantis$66K
- Tatiana ClarkBradenton$34K
- Brandi LigonWinter Park$27K
- Boni MayOrlando$22K
- Dennis VerducciMiami$22K
- Christina Duffy-HenriquesMaitland$19K
- Nichole StanleyNaples$18K
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.