Pamela Ralls
Family Medicine · Carrollton, MONPI 1023252541
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 100.0% of the total across 89 separate payments, which is the pattern of a clinician who attends manufacturer presentations rather than one with a consulting arrangement. 25 manufacturers reported payments, led by AbbVie at 31.3% of the total.
Across 89 payments — averaging $18.16 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- AbbVie$505
- Lilly USA, LLC$150
- Astellas Pharma US Inc$118
- Novo Nordisk$97
- Boehringer Ingelheim$91
- AstraZeneca$87
- plus $568 from 19 others
Across 3 payments — averaging $6005.50 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.
- Eli Lilly$18K
What the payments were for
- Food & beverage$1,616100%
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 | 26 | $505 |
| Lilly USA, LLC | 9 | $150 |
| Astellas Pharma US Inc | 5 | $118 |
| Novo Nordisk | 6 | $97 |
| Boehringer Ingelheim | 4 | $91 |
| AstraZeneca | 6 | $87 |
| Sanofi-aventis U.S. LLC | 2 | $52 |
| Novartis | 3 | $51 |
| Lundbeck LLC | 3 | $51 |
| Teva Pharmaceuticals USA, Inc. | 3 | $46 |
| Amgen | 3 | $44 |
| E.r. Squibb & Sons, L.L.C. | 2 | $36 |
| Abbott | 2 | $33 |
| Pfizer | 2 | $33 |
| Organon | 2 | $32 |
| Johnson & Johnson | 2 | $27 |
| Boston Scientific | 1 | $22 |
| Merck | 1 | $22 |
| Kowa Pharmaceuticals America, Inc. | 1 | $19 |
| Otsuka America Pharmaceutical, Inc. | 1 | $19 |
| Circassia Inc. | 1 | $19 |
| ITI, Inc. (d/b/a Intra-cellular Therapies, Inc.) | 1 | $17 |
| Sumitomo Pharma America, Inc. | 1 | $16 |
| Nestle Healthcare Nutrition Inc. | 1 | $15 |
| Bayer | 1 | $13 |
How this compares
$1,616 in reported general payments places this provider in the 70th percentile of 2,203 family medicine providers in Missouri.
Most prescribed under Part D
| Drug | Claims | Cost to plans & patients |
|---|---|---|
| IngrezzaValbenazine Tosylate | 13 | $104,011 |
| Invega SustennaPaliperidone Palmitate | 24 | $86,941 |
| TrulicityDulaglutide | 79 | $80,396 |
| OzempicSemaglutide | 72 | $76,579 |
| EliquisApixaban | 87 | $45,753 |
| MounjaroTirzepatide | 28 | $33,160 |
| VraylarCariprazine Hcl | 21 | $27,576 |
| RybelsusSemaglutide | 19 | $27,370 |
| JanuviaSitagliptin Phosphate | 36 | $20,039 |
| XareltoRivaroxaban | 39 | $19,987 |
| MyrbetriqMirabegron | 66 | $17,724 |
| FarxigaDapagliflozin Propanediol | 32 | $12,357 |
| EntrestoSacubitril/Valsartan | 22 | $11,687 |
| LinzessLinaclotide | 22 | $11,413 |
| Combivent RespimatIpratropium/Albuterol Sulfate | 19 | $9,688 |
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 |
|---|---|---|
| Lilly USA, LLCTrulicity, Mounjaro | $150 | $113,556107 claims |
| Novo NordiskOzempic, Rybelsus, Fiasp | $97 | $111,711104 claims |
| Johnson & JohnsonInvega Sustenna, Xarelto | $27 | $106,92863 claims |
| PfizerEliquis | $33 | $45,75387 claims |
| AbbVieVraylar, Linzess | $505 | $38,98943 claims |
| Boehringer IngelheimCombivent Respimat, Spiriva Respimat, Tradjenta | $91 | $23,11450 claims |
| MerckJanuvia | $22 | $20,03936 claims |
| Astellas Pharma US IncMyrbetriq | $118 | $17,72466 claims |
| AstraZenecaFarxiga | $87 | $12,35732 claims |
| NovartisEntresto | $51 | $11,68722 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 70th percentile of 2,203 family medicine providers in Missouri.
Other family medicine in Carrollton
- Andrew HorineCarrollton$19K
- Stephen AdamsSpringfield$636K
- Justin PuckettKirksville$568K
- Matthew BeckerditeOfallon$225K
- Roger CadySpringfield$175K
- James LasalleExcelsior Springs$130K
- Matthew TiefenbrunnSullivan$105K
- Ayobami OduwoleGrandview$92K
- Michael DonovanSaint Louis$78K
- Blair ThedingerKansas City$71K
Where these figures come from
- Payments: CMS Open Payments, program years 2019–2025 (publication P06302026_06032026).
- Identity: NPPES NPI Registry, July 2026.