Rajshekar Narasimaiah, MD
Internal Medicine · Bethany Beach, DENPI 1457367088
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 97.2% of the total across 316 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 38 manufacturers, the largest accounting for just 13.0% — the pattern of someone who eats at a lot of different presentations. Among internal medicine clinicians in DE 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 316 payments — averaging $20.99 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Neurocrine Biosciences, Inc.$864
- AbbVie$744
- Vanda Pharmaceuticals Inc.$496
- Novo Nordisk$427
- Amgen$411
- Astellas Pharma US Inc$387
- plus $3K from 32 others
What the payments were for
- Food & beverage$6,44597%
- Education$1893%
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 |
|---|---|---|
| Neurocrine Biosciences, Inc. | 70 | $864 |
| AbbVie(2 entities) | 40 | $744 |
| Vanda Pharmaceuticals Inc. | 20 | $496 |
| Novo Nordisk | 19 | $427 |
| Amgen | 16 | $411 |
| Astellas Pharma US Inc | 13 | $387 |
| Takeda Pharmaceuticals U.S.A., Inc. | 19 | $356 |
| Boehringer Ingelheim | 4 | $325 |
| Lundbeck LLC | 16 | $281 |
| Teva Pharmaceuticals USA, Inc. | 9 | $243 |
| Eisai Inc. | 7 | $223 |
| Lilly USA, LLC | 8 | $194 |
| Alkermes, Inc. | 4 | $190 |
| Otsuka America Pharmaceutical, Inc. | 9 | $174 |
| Exact Sciences | 6 | $125 |
| Idorsia Pharmaceuticals US Inc | 3 | $115 |
| AstraZeneca | 6 | $110 |
| Mylan Specialty L.p. | 4 | $101 |
| Axsome Therapeutics, Inc. | 4 | $100 |
| ITI, Inc. (d/b/a Intra-cellular Therapies, Inc.) | 5 | $89 |
| Pfizer | 5 | $88 |
| Vivus LLC | 1 | $79 |
| Sunovion Pharmaceuticals Inc. | 4 | $74 |
| Amarin Pharma, Inc. | 4 | $67 |
| Johnson & Johnson | 2 | $50 |
| GSK | 3 | $45 |
| E.r. Squibb & Sons, L.L.C. | 2 | $45 |
| Phathom Pharmaceuticals, Inc. | 2 | $31 |
| Bayer | 2 | $31 |
| Ardelyx, Inc. | 1 | $29 |
| Tactile Systems Technology Inc | 1 | $26 |
| Abbott | 1 | $19 |
| Biohaven Pharmaceuticals, Inc. | 1 | $18 |
| Neuronetics, Inc. | 1 | $17 |
| Alnylam Pharmaceuticals Inc. | 1 | $16 |
| Vertos Medical, Inc. | 1 | $16 |
| Irhythm Technologies, Inc. | 1 | $14 |
| Vistapharm, Inc. | 1 | $14 |
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
$6,634 in reported general payments places this provider in the 90th percentile of 477 internal medicine providers in Delaware.
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 |
|---|---|---|
| IngrezzaValbenazine Tosylate | 16 | $167,916 |
| OzempicSemaglutide | 109 | $123,215 |
| EliquisApixaban | 53 | $76,365 |
| JardianceEmpagliflozin | 29 | $45,282 |
| MounjaroTirzepatide | 12 | $30,388 |
| JanuviaSitagliptin Phosphate | 52 | $26,651 |
| LinzessLinaclotide | 29 | $24,981 |
| MyrbetriqMirabegron | 20 | $24,771 |
| Rosuvastatin Calcium | 981 | $12,110 |
| Divalproex Sodium | 356 | $10,285 |
| FarxigaDapagliflozin Propanediol | 13 | $9,741 |
| Levothyroxine Sodium | 910 | $8,035 |
| Lactulose | 319 | $7,595 |
| Atorvastatin Calcium | 771 | $7,540 |
| Levetiracetam | 312 | $6,747 |
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 |
|---|---|---|
| Neurocrine Biosciences, Inc.Ingrezza | $864 | $167,91616 claims |
| Novo NordiskOzempic | $427 | $123,215109 claims |
| PfizerEliquis | $88 | $76,36553 claims |
| Boehringer IngelheimJardiance | $325 | $45,28229 claims |
| Lilly USA, LLCMounjaro | $194 | $30,38812 claims |
| AbbVieLinzess, Synthroid | $744 | $29,584122 claims |
| Astellas Pharma US IncMyrbetriq | $387 | $24,77120 claims |
| AstraZenecaFarxiga | $110 | $9,74113 claims |
| Teva Pharmaceuticals USA, Inc.Loxapine | $243 | $2,839117 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 90th percentile of 477 internal medicine providers in Delaware.
Other internal medicine in Bethany Beach
- Seth IvinsNewark$384K
- Beshara HelouGeorgetown$143K
- Tabassum SalamNewark$62K
- Fabricio AlarconGeorgetown$30K
- Jose CastroWilmington$27K
- Marcia Gina CastroWilmington$24K
- Bhaskar PalekarLewes$22K
- Fadi DamouniMillsboro$17K
- Rene BadilloBear$16K
- Robert KopeckiWilmington$15K
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.