Nithin Karakala, MD
Nephrology · Little Rock, ARNPI 1639356827
Payments from drug & device makers
What this record shows
6 manufacturers reported payments, led by Otsuka America Pharmaceutical, Inc. at 51.7% of the total. Reporting peaked in 2020 at $382 and has fallen 80.4% since, to $75 in 2025. That places this record below the midpoint for nephrology clinicians in AR, where the typical reported total is $925.
Across 12 payments — averaging $61.61 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Otsuka America Pharmaceutical, Inc.$382
- Vifor Pharma, Inc.$222
- Nxstage Medical, Inc.$75
- Travere Therapeutics, Inc.$25
- AstraZeneca$22
- Calliditas Therapeutics US Inc.$14
Across 14 payments — averaging $3958.53 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.
- Fresenius USA Marketing, Inc.$49K
- Fresenius Medical Care Renal Therapies Group, LLC.$6K
What the payments were for
- Food & beverage$31843%
- Education$42157%
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 |
|---|---|---|
| Otsuka America Pharmaceutical, Inc. | 1 | $382 |
| Vifor Pharma, Inc. | 2 | $222 |
| Nxstage Medical, Inc. | 1 | $75 |
| Travere Therapeutics, Inc. | 6 | $25 |
| AstraZeneca | 1 | $22 |
| Calliditas Therapeutics US Inc. | 1 | $14 |
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
$739 in reported general payments places this provider in the 45th percentile of 85 nephrology providers in Arkansas.
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 |
|---|---|---|
| Mycophenolate Mofetil | 11 | $3,217 |
| Bumetanide | 13 | $1,071 |
| Torsemide | 48 | $669 |
| Calcitriol | 22 | $665 |
| Nifedipine ErNifedipine | 13 | $429 |
| Furosemide | 30 | $395 |
| Potassium Chloride | 23 | $372 |
| Losartan Potassium | 38 | $317 |
| Lisinopril | 33 | $310 |
| Doxazosin Mesylate | 26 | $213 |
| Carvedilol | 22 | $179 |
| Amlodipine Besylate | 22 | $111 |
| Allopurinol | 26 | $106 |
| Hydrochlorothiazide | 20 | $99 |
| Glipizide ErGlipizide | 11 | $94 |
Paid to pharmacies, not to this prescriber.
Other nephrology in Little Rock
- Luis JuncosLittle Rock$66K
- John HeifnerLittle Rock$45K
- John ArthurLittle Rock$7K
- Moses EjioforLittle Rock$6K
- Alex DavidLittle Rock$6K
- Prajwal ChevireddyLittle Rock$3K
- Muhammad AlamLittle Rock$2K
- Kashaf RasheedLittle Rock$2K
- Fakhar IjazLittle Rock$2K
- Garry GlascoLittle Rock$459
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.