Paul Graham, MD
Endocrinology, Diabetes & Metabolism · Vero Beach, FLNPI 1881777332
Payments from drug & device makers
What this record shows
This record is dominated by speaking fees: $65,050 of the $77,483 with a category attached, or 84.0%. AstraZeneca accounts for 86.3% of it on its own, with 25 other manufacturers making up the rest. Reporting peaked in 2019 at $49,585 and has fallen 98.5% since, to $725 in 2025. Among endocrinology, diabetes & metabolism clinicians in FL with any reported payments, this total sits in the top 10% — high for the specialty, which is a reason to read the composition above rather than the number alone.
Across 418 payments — averaging $185.37 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- AstraZeneca$67K
- AbbVie$4K
- Sanofi-aventis U.S. LLC$1K
- Novo Nordisk$1K
- Lilly USA, LLC$921
- Bayer$845
- plus $2K from 20 others
What the payments were for
- Speaking & faculty fees$65,05084%
- Travel & lodging$3,1694%
- Food & beverage$9,09512%
- Education$1090%
- Gifts$590%
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 |
|---|---|---|
| AstraZeneca | 120 | $66,885 |
| AbbVie | 10 | $4,432 |
| Sanofi-aventis U.S. LLC | 52 | $1,090 |
| Novo Nordisk | 77 | $1,069 |
| Lilly USA, LLC | 34 | $921 |
| Bayer | 24 | $845 |
| Boehringer Ingelheim | 21 | $410 |
| Amgen(2 entities) | 9 | $371 |
| Abbott | 13 | $281 |
| Medtronic(2 entities) | 10 | $195 |
| Insulet Corporation | 7 | $150 |
| Tandem Diabetes Care, Inc. | 6 | $131 |
| Dexcom, Inc. | 7 | $117 |
| Mannkind Corporation | 3 | $106 |
| Corcept Therapeutics | 4 | $97 |
| Radius Health, Inc. | 5 | $92 |
| Johnson & Johnson | 3 | $56 |
| Merck | 3 | $41 |
| Amarin Pharma, Inc. | 2 | $37 |
| Shire North American Group Inc | 2 | $37 |
| Novartis | 1 | $29 |
| BD | 1 | $24 |
| Neurocrine Biosciences, Inc. | 1 | $24 |
| Vivus LLC | 1 | $17 |
| Clarus Therapeutics Inc. | 1 | $13 |
| Valeritas, 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
$77,483 in reported general payments places this provider in the 90th percentile of 586 endocrinology, diabetes & metabolism providers in Florida.
See all endocrinology, diabetes & metabolism providers in Florida →
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 | 351 | $455,813 |
| MounjaroTirzepatide | 392 | $434,901 |
| TrulicityDulaglutide | 216 | $309,339 |
| JardianceEmpagliflozin | 248 | $229,037 |
| FarxigaDapagliflozin Propanediol | 162 | $168,376 |
| Bydureon BciseExenatide Microspheres | 58 | $95,861 |
| RybelsusSemaglutide | 56 | $83,256 |
| Toujeo SolostarInsulin Glargine,hum.Rec.Anlog | 70 | $55,045 |
| Tresiba Flextouch U-200Insulin Degludec | 40 | $51,111 |
| JanuviaSitagliptin Phosphate | 40 | $48,655 |
| TradjentaLinagliptin | 41 | $44,400 |
| Fiasp FlextouchInsulin Aspart (Niacinamide) | 37 | $39,823 |
| SynthroidLevothyroxine Sodium | 431 | $39,755 |
| Tresiba Flextouch U-100Insulin Degludec | 59 | $34,223 |
| Humulin R U-500 KwikpenInsulin Regular, Human | 14 | $25,769 |
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, LLCMounjaro, Trulicity | $921 | $744,240608 claims |
| Novo NordiskOzempic, Rybelsus, Fiasp | $1,069 | $549,033420 claims |
| Boehringer IngelheimJardiance, Tradjenta | $410 | $273,438289 claims |
| AstraZenecaFarxiga | $66,885 | $168,376162 claims |
| MerckJanuvia, Janumet, Janumet Xr | $41 | $79,23666 claims |
| AbbVieSynthroid | $4,432 | $39,755431 claims |
| BayerKerendia | $845 | $15,01916 claims |
| Sanofi-aventis U.S. LLCLantus | $1,090 | $4,11723 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 90th percentile of 586 endocrinology, diabetes & metabolism providers in Florida.
Other endocrinology, diabetes & metabolism in Vero Beach
- Jay SkylerMiami$2.2M
- Arelis MaderaPort Charlotte$1.7M
- Damon TantonOrlando$1.2M
- Gaston PonteMelbourne$906K
- Brian LakeLargo$888K
- David SuttonJacksonville$783K
- Mae Sheikh AliJacksonville$751K
- Richard PratleyOrlando$735K
- Lee MetchickDeland$728K
- Misha DenhamCoral Gables$673K
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.