Paul Pagano, MD
Orthopaedic Surgery of the Spine · St Petersburg, FLNPI 1215930912
Payments from drug & device makers
What this record shows
This record is dominated by ownership interests: $124,999 of the $163,557 with a category attached, or 76.4%. Kalitec Direct LLC accounts for 98.3% of it on its own, with 22 other manufacturers making up the rest. Reporting peaked in 2020 at $48,909 and has fallen 91.6% since, to $4,085 in 2025.
Across 71 payments — averaging $2303.62 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Kalitec Direct LLC$161K
- Spinal Elements, Inc.$1K
- Medtronic$342
- Si-bone, Inc.$229
- Innovation Technologies Inc$169
- Choice Spine, LLC$148
- plus $886 from 17 others
Across 7 payments — averaging $8899.00 each. An ownership or investment interest held by the physician or an immediate family member.
- Kalitec Direct LLC$62K
What the payments were for
- Royalty or licence$35,60422%
- Food & beverage$2,9542%
- Ownership interest$124,99976%
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 |
|---|---|---|
| Kalitec Direct LLC | 12 | $160,714 |
| Spinal Elements, Inc. | 9 | $1,069 |
| Medtronic(2 entities) | 9 | $342 |
| Si-bone, Inc. | 4 | $229 |
| Innovation Technologies Inc | 1 | $169 |
| Choice Spine, LLC | 1 | $148 |
| Nexxt Spine LLC | 1 | $131 |
| Intrinsic Therapeutics | 3 | $121 |
| Abbott | 5 | $100 |
| Boston Scientific | 4 | $88 |
| Arbor Pharmaceuticals, Inc. | 4 | $81 |
| Ferring Pharmaceuticals Inc. | 3 | $63 |
| Aesculap Implant Systems, LLC | 1 | $60 |
| Bioventus LLC | 3 | $44 |
| Johnson & Johnson | 1 | $38 |
| Amgen | 2 | $32 |
| Sanofi-aventis U.S. LLC | 2 | $25 |
| Vertex | 1 | $22 |
| AstraZeneca | 1 | $17 |
| Electronic Waveform Lab, Inc. | 1 | $17 |
| Pacira Therapeutics, Inc. | 1 | $17 |
| ERMI LLC | 1 | $17 |
| Relievant Medsystems, 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.
- CosmoLock$36,500
- Matira$10,640
- Matira Anterior Cervical System$9,096
- Medical Device$568
- Irrisept$169
- Blackhawk Cervical Spacer System$148
- Thunderbolt Minimally Invasive Pedicle Screw Systems$148
- VEO Lateral Interbody Fusion System$148
- Triton$148
- Stratofuse$148
- iFuse Implant$148
- UNiD$147
- Nexxt Spine Product Offerings$131
How this compares
$163,557 in reported general payments places this provider in the 75th percentile of 159 orthopaedic surgery of the spine providers in Florida.
See all orthopaedic surgery of the spine 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 |
|---|---|---|
| Tizanidine Hcl | 217 | $1,859 |
| Oxycodone-AcetaminophenOxycodone Hcl/Acetaminophen | 150 | $1,625 |
| Methylprednisolone | 89 | $648 |
| Gabapentin | 58 | $542 |
| Celecoxib | 18 | $483 |
| Cyclobenzaprine Hcl | 41 | $401 |
| Hydrocodone-AcetaminophenHydrocodone/Acetaminophen | 45 | $332 |
| Tramadol Hcl | 98 | $326 |
| Baclofen | 40 | $255 |
| Mupirocin | 19 | $154 |
| Pregabalin | 13 | $95 |
| Oxycodone Hcl | 11 | $52 |
| Diazepam | 15 | $20 |
| Meloxicam | 13 | $18 |
Paid to pharmacies, not to this prescriber.
Other orthopaedic surgery of the spine in St Petersburg
- Harry ShufflebargerMiami$3.5M
- Paul KellerMelbourne$3.4M
- Thomas SweeneySarasota$2.3M
- Geoffrey CronenTampa$2.2M
- James BillysOdessa$1.9M
- Mark DekutoskiDestin$1.8M
- Farhan SiddiqiOdessa$1.7M
- Samuel JosephSafety Harbor$1.7M
- Thomas ErricoMiami$1.6M
- Constantine ToumbisCrystal River$1.6M
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.