Nathan Sprengel, DO
General Practice · New Madrid, MONPI 1912260597
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 99.7% of the total across 471 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 35 manufacturers, the largest accounting for just 11.9% — the pattern of someone who eats at a lot of different presentations. Among general practice clinicians in MO 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 471 payments — averaging $15.33 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Boehringer Ingelheim$861
- AstraZeneca$840
- Lilly USA, LLC$761
- Novo Nordisk$694
- Pfizer$385
- Merck$380
- plus $3K from 29 others
What the payments were for
- Food & beverage$7,201100%
- Education$190%
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 |
|---|---|---|
| Boehringer Ingelheim | 76 | $861 |
| AstraZeneca | 42 | $840 |
| Lilly USA, LLC | 57 | $761 |
| Novo Nordisk | 44 | $694 |
| Pfizer | 29 | $385 |
| Merck | 26 | $380 |
| Amarin Pharma, Inc. | 21 | $307 |
| Otsuka America Pharmaceutical, Inc. | 17 | $299 |
| Novartis | 18 | $294 |
| Amgen | 15 | $260 |
| Phathom Pharmaceuticals, Inc. | 2 | $215 |
| Salix Pharmaceuticals, A Division Of Bausch Health US, LLC | 13 | $202 |
| GSK | 16 | $187 |
| AbbVie(2 entities) | 9 | $180 |
| Bayer | 9 | $168 |
| Radius Health, Inc. | 11 | $163 |
| Corcept Therapeutics | 7 | $161 |
| Kowa Pharmaceuticals America, Inc. | 14 | $159 |
| Viatris Specialty LLC | 6 | $106 |
| Takeda Pharmaceuticals U.S.A., Inc. | 8 | $103 |
| Johnson & Johnson | 7 | $91 |
| Mylan Specialty L.p. | 4 | $74 |
| Astellas Pharma US Inc | 4 | $60 |
| Eisai Inc. | 2 | $36 |
| Xeris Pharmaceuticals, Inc. | 2 | $34 |
| Seqirus USA Inc | 1 | $31 |
| Dexcom, Inc. | 2 | $31 |
| Exact Sciences | 2 | $26 |
| ITI, Inc. (d/b/a Intra-cellular Therapies, Inc.) | 1 | $20 |
| Organon | 1 | $19 |
| Sanofi Pasteur Inc. | 1 | $19 |
| Biohaven Pharmaceutical Holding Company Ltd. | 1 | $17 |
| Verona Pharma, Inc. | 1 | $15 |
| Electromed, Inc. | 1 | $12 |
| Sunovion Pharmaceuticals Inc. | 1 | $10 |
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.
- VOQUEZNA$198
How this compares
$7,220 in reported general payments places this provider in the 95th percentile of 1,446 general practice providers in Missouri.
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 |
|---|---|---|
| OzempicSemaglutide | 140 | $151,234 |
| JardianceEmpagliflozin | 66 | $73,275 |
| FarxigaDapagliflozin Propanediol | 65 | $57,995 |
| EliquisApixaban | 90 | $57,620 |
| TrulicityDulaglutide | 55 | $54,189 |
| MounjaroTirzepatide | 42 | $44,701 |
| RybelsusSemaglutide | 43 | $40,620 |
| LinzessLinaclotide | 60 | $40,534 |
| RexultiBrexpiprazole | 23 | $33,600 |
| TradjentaLinagliptin | 32 | $29,390 |
| Breztri AerosphereBudesonide/Glycopyr/Formoterol | 45 | $28,665 |
| Trelegy ElliptaFluticasone/Umeclidin/Vilanter | 38 | $26,527 |
| Dexlansoprazole DrDexlansoprazole | 73 | $20,087 |
| EntrestoSacubitril/Valsartan | 23 | $18,194 |
| TrintellixVortioxetine Hydrobromide | 29 | $17,804 |
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 |
|---|---|---|
| Novo NordiskOzempic, Rybelsus, Wegovy | $694 | $207,512194 claims |
| Boehringer IngelheimJardiance, Tradjenta, Synjardy Xr, Combivent Respimat | $861 | $116,655121 claims |
| Lilly USA, LLCTrulicity, Mounjaro | $761 | $98,88997 claims |
| AstraZenecaFarxiga, Breztri Aerosphere, Symbicort | $840 | $89,747123 claims |
| GSKTrelegy Ellipta, Anoro Ellipta, Shingrix, Breo Ellipta, Incruse Ellipta | $187 | $65,174142 claims |
| PfizerEliquis | $385 | $57,62090 claims |
| AbbVieLinzess | $180 | $40,53460 claims |
| Otsuka America Pharmaceutical, Inc.Rexulti | $299 | $33,60023 claims |
| MerckBelsomra, Janumet Xr | $380 | $25,43051 claims |
| NovartisEntresto | $294 | $18,19423 claims |
| Takeda Pharmaceuticals U.S.A., Inc.Trintellix | $103 | $17,80429 claims |
| Astellas Pharma US IncMyrbetriq | $60 | $16,27627 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 1,446 general practice providers in Missouri.
Other general practice in New Madrid
- Baron GrutterGladstone$445K
- Arthur GreenbergKansas City$241K
- Robert CalaluceColumbia$189K
- Suraiya SiddiqueMount Vernon$61K
- John FluckeLees Summit$60K
- Rex HudsonSaint Louis$49K
- David KaelinCape Girardeau$27K
- Nadeemuddin QureshiSaint Louis$22K
- Michael McKenzieHannibal$20K
- Robert McGrawCameron$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.