Rachel Safran, MD
Internal Medicine · Spokane, WANPI 1437413762
Payments from drug & device makers
What this record shows
This record is dominated by speaking fees: $21,820 of the $31,220 with a category attached, or 69.9%. Gilead accounts for 92.9% of it on its own, with 6 other manufacturers making up the rest. Among internal medicine clinicians in WA with any reported payments, this total sits in the top 5% — high for the specialty, which is a reason to read the composition above rather than the number alone.
Across 98 payments — averaging $318.57 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Gilead$29K
- Viiv Healthcare Company$2K
- Tandem Diabetes Care, Inc.$278
- Dexcom, Inc.$146
- Boehringer Ingelheim$125
- EMD Serono, Inc.$102
- plus $48 from 1 others
Across 57 payments — averaging $10,488 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.
- Merck$438K
- Gilead$107K
- Genentech, Inc.$31K
- AstraZeneca$22K
What the payments were for
- Speaking & faculty fees$21,82070%
- Travel & lodging$3,47311%
- Food & beverage$5,92719%
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 |
|---|---|---|
| Gilead | 62 | $29,005 |
| Viiv Healthcare Company | 28 | $1,517 |
| Tandem Diabetes Care, Inc. | 3 | $278 |
| Dexcom, Inc. | 2 | $146 |
| Boehringer Ingelheim | 1 | $125 |
| EMD Serono, Inc. | 1 | $102 |
| BETA Bionics, Inc. | 1 | $48 |
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
$31,220 in reported general payments places this provider in the 95th percentile of 2,038 internal medicine providers in Washington.
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 |
|---|---|---|
| BiktarvyBictegrav/Emtricit/Tenofov Ala | 463 | $1,865,978 |
| DovatoDolutegravir Sodium/Lamivudine | 75 | $221,610 |
| TriumeqAbacavir/Dolutegravir/Lamivudi | 58 | $215,713 |
| PrezcobixDarunavir/Cobicistat | 77 | $198,338 |
| OdefseyEmtricitab/Rilpiviri/Tenof Ala | 55 | $196,091 |
| TivicayDolutegravir Sodium | 74 | $171,929 |
| CabenuvaCabotegravir/Rilpivirine | 17 | $114,939 |
| RukobiaFostemsavir Tromethamine | 13 | $112,683 |
| DescovyEmtricitabine/Tenofov Alafenam | 44 | $93,984 |
| PifeltroDoravirine | 42 | $76,404 |
| JardianceEmpagliflozin | 49 | $68,317 |
| EliquisApixaban | 65 | $62,128 |
| JulucaDolutegravir/Rilpivirine | 18 | $59,794 |
| RybelsusSemaglutide | 42 | $55,472 |
| OzempicSemaglutide | 34 | $49,685 |
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 |
|---|---|---|
| GileadBiktarvy, Descovy | $29,005 | $1,959,962507 claims |
| Viiv Healthcare CompanyDovato, Triumeq, Tivicay, Cabenuva, Rukobia | $1,517 | $896,667255 claims |
| Boehringer IngelheimJardiance, Spiriva Respimat | $125 | $74,25961 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 95th percentile of 2,038 internal medicine providers in Washington.
Other internal medicine in Spokane
- Radica AlicicSpokane$54K
- Catherine LarueSpokane$36K
- Peter ShalitSeattle$1M
- Lawrence LoebBellevue$784K
- Shawna PurcellOlympia$294K
- Scott RamseySeattle$230K
- Michael CairnsSeattle$144K
- Peiqing QianSeattle$117K
- Alan KellySpokane Valley$96K
- Emily EgdaminWenatchee$81K
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.