Rafael Marrero, MD
Otolaryngology · Conway, ARNPI 1437152329
Payments from drug & device makers
What this record shows
The money is spread across several categories — food and beverage (52.0%), travel and lodging and consulting fees — rather than concentrated in one kind of arrangement. 15 manufacturers reported payments, led by Intersect ENT, Inc. at 57.3% of the total. Reporting peaked in 2021 at $2,445 and has fallen 87.3% since, to $309 in 2025. Among otolaryngology clinicians in AR 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 58 payments — averaging $70.84 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Intersect ENT, Inc.$2K
- Jazz Pharmaceuticals Inc.$689
- Stryker$210
- GSK$205
- Aerin Medical Inc.$188
- Optinose US, Inc.$162
- plus $298 from 9 others
What the payments were for
- Consulting fees$1504%
- Travel & lodging$1,75643%
- Food & beverage$2,13652%
- Education$672%
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 |
|---|---|---|
| Intersect ENT, Inc. | 11 | $2,355 |
| Jazz Pharmaceuticals Inc. | 7 | $689 |
| Stryker | 7 | $210 |
| GSK | 12 | $205 |
| Aerin Medical Inc. | 3 | $188 |
| Optinose US, Inc. | 3 | $162 |
| Harmony Biosciences LLC | 3 | $75 |
| Regeneron Healthcare Solutions, Inc. | 3 | $55 |
| Hikma Pharmaceuticals USA | 3 | $53 |
| Greer Laboratories, Inc. | 1 | $32 |
| Smith+Nephew | 1 | $22 |
| Merck | 1 | $20 |
| Cook Medical LLC | 1 | $15 |
| Acclarent, Inc | 1 | $15 |
| Alk-abello, Inc | 1 | $12 |
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.
- PROPEL$2,233
- SINUVA$2,233
- XYWAV$383
- XYREM$150
- Xhance$125
- VIVAER STYLUS$124
- RHINAER STYLUS$124
- SUNOSI$119
How this compares
$4,109 in reported general payments places this provider in the 90th percentile of 72 otolaryngology providers in Arkansas.
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 |
|---|---|---|
| Azelastine Hcl | 43 | $917 |
| Fluocinolone Acetonide Oil | 19 | $850 |
| Fluticasone Propionate | 51 | $451 |
| Prednisone | 32 | $32 |
Paid to pharmacies, not to this prescriber.
Other otolaryngology in Conway
- Jeffrey KirschConway$6K
- Patrick FraleyConway$5K
- Phillip BallingerConway$1K
- Collie ShawConway$1K
- James StroudConway$769
- Patricia BellHarrison$82K
- Cory VaughnSpringdale$7K
- Sharon TomaskiEl Dorado$5K
- Tyler BoneJonesboro$5K
- Matthew BridgesRogers$4K
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.