Paul Merkle
Pediatric Orthopaedic Surgery · Los Angeles, CANPI 1962549717
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 100.0% of the total across 23 separate payments, which is the pattern of a clinician who attends manufacturer presentations rather than one with a consulting arrangement. 8 manufacturers reported payments, led by Johnson & Johnson at 26.6% of the total. Reporting peaked in 2019 at $699 and has fallen 89.8% since, to $71 in 2024.
Across 23 payments — averaging $69.97 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Johnson & Johnson$428
- Smith+Nephew$415
- Xtant Medical Inc$327
- Stryker$150
- Zimmer Biomet$123
- Advanced Orthopaedic Solutions, Inc.$94
- plus $74 from 2 others
What the payments were for
- Food & beverage$1,609100%
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 |
|---|---|---|
| Johnson & Johnson | 9 | $428 |
| Smith+Nephew | 4 | $415 |
| Xtant Medical Inc | 3 | $327 |
| Stryker | 1 | $150 |
| Zimmer Biomet | 1 | $123 |
| Advanced Orthopaedic Solutions, Inc. | 1 | $94 |
| Bioventus LLC | 3 | $56 |
| KCI USA, Inc. | 1 | $18 |
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
$1,609 in reported general payments places this provider in the 55th percentile of 63 pediatric orthopaedic surgery providers in California.
See all pediatric orthopaedic surgery providers in California →
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.
Other pediatric orthopaedic surgery in Los Angeles
- Lindsay AndrasLos Angeles$158K
- Robert KayLos Angeles$9K
- Mauricio SilvaLos Angeles$4K
- Amelia LindgrenLos Angeles$3K
- Graham FedorakLos Angeles$2K
- Thomas GroganLos Angeles$328
- Vernon ToloLos Angeles$325
- Stephanie LamerLos Angeles$98
- William OppenheimLos Angeles$68
- Robert ChoBeverly Hills$496K
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.