Rachel Spagnoli
Nurse Practitioner · Alpharetta, GANPI 1255890943
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 100.0% of the total across 132 separate payments, which is the pattern of a clinician who attends manufacturer presentations rather than one with a consulting arrangement. It is spread thinly across 29 manufacturers, the largest accounting for just 14.1% — the pattern of someone who eats at a lot of different presentations. 2025 is the largest year on record at $1,218, 3.3 times the $365 reported in 2023.
Across 132 payments — averaging $19.16 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Novo Nordisk$356
- Lilly USA, LLC$293
- Noven Therapeutics, LLC$186
- Pfizer$179
- AstraZeneca$171
- Astellas Pharma US Inc$151
- plus $1K from 23 others
What the payments were for
- Food & beverage$2,528100%
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 |
|---|---|---|
| Novo Nordisk | 24 | $356 |
| Lilly USA, LLC | 18 | $293 |
| Noven Therapeutics, LLC | 9 | $186 |
| Pfizer | 8 | $179 |
| AstraZeneca | 9 | $171 |
| Astellas Pharma US Inc | 6 | $151 |
| AbbVie | 7 | $136 |
| Exact Sciences | 8 | $129 |
| Amgen | 6 | $97 |
| Salix Pharmaceuticals, A Division Of Bausch Health US, LLC | 4 | $75 |
| GSK | 4 | $69 |
| Harmony Biosciences LLC | 2 | $68 |
| Johnson & Johnson | 2 | $58 |
| Xeris Pharmaceuticals, Inc. | 3 | $55 |
| Bayer | 2 | $54 |
| Axsome Therapeutics, Inc. | 2 | $49 |
| ITI, Inc. (d/b/a Intra-cellular Therapies, Inc.) | 3 | $48 |
| Dexcom, Inc. | 2 | $41 |
| Inspire Medical Systems, Inc. | 1 | $39 |
| Merck | 2 | $37 |
| Baxter Healthcare | 2 | $37 |
| Boston Scientific | 1 | $36 |
| Saluda Medical Americas, Inc. | 1 | $33 |
| Sanofi-aventis U.S. LLC | 1 | $26 |
| Boehringer Ingelheim | 1 | $23 |
| Corium, LLC | 1 | $23 |
| Esperion Therapeutics, Inc. | 1 | $22 |
| Medtronic | 1 | $19 |
| Actelion Pharmaceuticals US, Inc. | 1 | $18 |
How this compares
$2,528 in reported general payments places this provider in the 85th percentile of 3,328 nurse practitioner providers in Georgia.
Most prescribed under Part D
| Drug | Claims | Cost to plans & patients |
|---|---|---|
| Advair HfaFluticasone Propion/Salmeterol | 11 | $5,125 |
| Atorvastatin Calcium | 15 | $137 |
| Lisinopril | 14 | $81 |
| Amlodipine Besylate | 13 | $21 |
Paid to pharmacies, not to this prescriber.
Other nurse practitioner in Alpharetta
- Brett PerkinsAlpharetta$14K
- Victor CzerkasijDalton$505K
- Kennon Mc CollumStockbridge$364K
- Tajuana BradleyJohns Creek$256K
- Jessica AdkinsSavannah$226K
- Janice McAlisterAtlanta$221K
- Laura ElledgeAtlanta$177K
- Afsha HussainiKennesaw$122K
- Elizabeth TyeAlbany$78K
- Luis PoloSavannah$70K
Where these figures come from
- Payments: CMS Open Payments, program years 2019–2025 (publication P06302026_06032026).
- Identity: NPPES NPI Registry, July 2026.