Nirosshan Thiruchelvam, MD
Internal Medicine · Cleveland, OHNPI 1912262866
Payments from drug & device makers
What this record shows
The money is spread across several categories — food and beverage (33.5%), travel and lodging and education — rather than concentrated in one kind of arrangement. 31 manufacturers reported payments, led by Intuitive Surgical at 31.0% of the total. Reporting peaked in 2024 at $6,593 and has fallen 51.4% since, to $3,203 in 2025. Among internal medicine clinicians in OH 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 224 payments — averaging $74.48 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Intuitive Surgical$5K
- Sanofi$5K
- AstraZeneca$2K
- Noah Medical Corporation$1K
- Boehringer Ingelheim$1K
- GSK$1K
- plus $2K from 25 others
Across 9 payments — averaging $3908.91 each. Payments tied to a research study. These frequently flow through the physician to a hospital or research institution rather than to the physician personally.
- GSK$20K
- AstraZeneca$15K
What the payments were for
- Consulting fees$1,83611%
- Speaking & faculty fees$2,28314%
- Travel & lodging$3,80223%
- Food & beverage$5,59334%
- Education$3,17019%
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 |
|---|---|---|
| Intuitive Surgical | 11 | $5,174 |
| Sanofi | 15 | $4,600 |
| AstraZeneca(2 entities) | 40 | $2,140 |
| Noah Medical Corporation | 6 | $1,175 |
| Boehringer Ingelheim | 33 | $1,012 |
| GSK | 52 | $1,003 |
| Actelion Pharmaceuticals US, Inc. | 13 | $382 |
| Grifols USA, LLC | 13 | $261 |
| Bayer | 5 | $96 |
| Sanofi-aventis U.S. LLC | 1 | $90 |
| Astellas Pharma US Inc | 2 | $80 |
| Inogen, Inc. | 5 | $73 |
| Philips North America LLC | 3 | $66 |
| Mylan Specialty L.p. | 2 | $57 |
| Baxter Healthcare | 2 | $54 |
| Medtronic | 1 | $43 |
| Pulmonx Corporation | 1 | $39 |
| Johnson & Johnson | 2 | $38 |
| E.r. Squibb & Sons, L.L.C. | 2 | $35 |
| Galvanize Therapeutics, Inc | 1 | $34 |
| Insmed, Inc. | 2 | $31 |
| Teva Pharmaceuticals USA, Inc. | 2 | $31 |
| Merck | 2 | $30 |
| Regeneron Healthcare Solutions, Inc. | 1 | $28 |
| United Therapeutics Corporation | 1 | $23 |
| Viatris Specialty LLC | 1 | $18 |
| Amgen | 1 | $15 |
| ZOLL Services LLC (a/k/a ZOLL Lifecor Corp) | 1 | $14 |
| La Jolla Pharmaceutical Company | 1 | $14 |
| Takeda Pharmaceuticals U.S.A., Inc. | 1 | $14 |
| Pfizer | 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.
- ION$3,000
- DUPIXENT$2,391
- Da Vinci Surgical System$1,748
- GALAXY$1,077
- NUCALA$250
How this compares
$16,684 in reported general payments places this provider in the 95th percentile of 4,428 internal medicine providers in Ohio.
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 |
|---|---|---|
| OfevNintedanib Esylate | 19 | $250,526 |
| Trelegy ElliptaFluticasone/Umeclidin/Vilanter | 269 | $213,169 |
| Breo ElliptaFluticasone/Vilanterol | 149 | $76,015 |
| Breztri AerosphereBudesonide/Glycopyr/Formoterol | 112 | $74,664 |
| Ambrisentan | 14 | $41,616 |
| NucalaMepolizumab | 12 | $40,371 |
| Stiolto RespimatTiotropium Br/Olodaterol Hcl | 36 | $27,213 |
| Spiriva RespimatTiotropium Bromide | 39 | $21,055 |
| Anoro ElliptaUmeclidinium Brm/Vilanterol Tr | 33 | $17,135 |
| Fluticasone-SalmeterolFluticasone Propion/Salmeterol | 88 | $16,798 |
| SymbicortBudesonide/Formoterol Fumarate | 40 | $9,376 |
| Budesonide-Formoterol FumarateBudesonide/Formoterol Fumarate | 31 | $8,026 |
| Albuterol Sulfate HfaAlbuterol Sulfate | 228 | $7,460 |
| Qvar RedihalerBeclomethasone Dipropionate | 16 | $5,721 |
| Advair HfaFluticasone Propion/Salmeterol | 14 | $5,693 |
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 |
|---|---|---|
| GSKTrelegy Ellipta, Breo Ellipta, Nucala, Anoro Ellipta | $1,003 | $346,689463 claims |
| Boehringer IngelheimOfev, Stiolto Respimat, Spiriva Respimat | $1,012 | $298,79394 claims |
| AstraZenecaBreztri Aerosphere, Symbicort | $2,140 | $84,040152 claims |
| Teva Pharmaceuticals USA, Inc.Qvar Redihaler | $31 | $5,72116 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 4,428 internal medicine providers in Ohio.
Other internal medicine in Cleveland
- Cyrus HarrisCleveland$726K
- Marina MagreyCleveland$312K
- Joshua LonginowCleveland$241K
- Emad MansoorCleveland$219K
- Syed BukhariCleveland$165K
- Vadim KoshkinCleveland$159K
- Suresh Kumar BalasubramanianCleveland$148K
- Christine Tanaka-EspositoCleveland$123K
- Carla HarwellCleveland$75K
- Amr MohamedCleveland$72K
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.