Nicolle Fischer
Physician Assistant · Ames, IANPI 1588928238
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 92.1% of the total across 456 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 23 manufacturers, the largest accounting for just 23.6% — the pattern of someone who eats at a lot of different presentations. Among physician assistant clinicians in IA 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 456 payments — averaging $19.47 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- AbbVie$2K
- Johnson & Johnson$1K
- Sanofi$681
- Dermavant Sciences, Inc.$646
- UCB, Inc.$553
- Galderma Laboratories, L.p.$548
- plus $3K from 17 others
What the payments were for
- Food & beverage$8,17692%
- Education$7038%
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 |
|---|---|---|
| AbbVie(2 entities) | 126 | $2,093 |
| Johnson & Johnson | 66 | $1,365 |
| Sanofi | 34 | $681 |
| Dermavant Sciences, Inc. | 38 | $646 |
| UCB, Inc. | 22 | $553 |
| Galderma Laboratories, L.p. | 19 | $548 |
| Lilly USA, LLC | 26 | $476 |
| E.r. Squibb & Sons, L.L.C. | 17 | $412 |
| Novartis | 16 | $409 |
| Regeneron Healthcare Solutions, Inc. | 20 | $397 |
| Sun Pharmaceutical Industries Inc. | 20 | $359 |
| Amgen | 12 | $237 |
| Pfizer | 11 | $192 |
| Sanofi-aventis U.S. LLC | 5 | $80 |
| Incyte Corporation | 4 | $80 |
| Arcutis Biotherapeutics, Inc. | 4 | $77 |
| Organon | 5 | $75 |
| Ortho Dermatologics, A Division Of Bausch Health US, LLC | 3 | $50 |
| Nabriva Therapeutics, PLC | 3 | $50 |
| LEO Pharma Inc. | 2 | $43 |
| Genentech USA, Inc. | 1 | $25 |
| Boehringer Ingelheim | 1 | $17 |
| Dermira, Inc. | 1 | $13 |
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
$8,878 in reported general payments places this provider in the 95th percentile of 1,140 physician assistant providers in Iowa.
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 |
|---|---|---|
| Metronidazole | 14 | $1,024 |
| Clobetasol Propionate | 13 | $821 |
| Doxycycline Hyclate | 17 | $740 |
| Fluocinonide | 12 | $359 |
| Ketoconazole | 16 | $307 |
| Triamcinolone Acetonide | 22 | $95 |
Paid to pharmacies, not to this prescriber.
Other physician assistant in Ames
- Katherine LemAmes$224K
- Meagen AndersonAmes$9K
- Jayson GesulgaUrbandale$878K
- Laurie ClairJohnston$293K
- Laura CunninghamWest Des Moines$128K
- Michon LeddyClive$73K
- Kyle HawkinsIowa City$42K
- Andrew MetzgerIowa City$37K
- Myrl HolidaIowa City$37K
- Kelly MerchieDavenport$15K
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.