Ralph Abi Hachem, MD
Otolaryngology · Durham, NCNPI 1285953430
Payments from drug & device makers
What this record shows
This record is dominated by travel and lodging: $5,422 of the $8,623 with a category attached, or 62.9%. Medtronic accounts for 75.7% of it on its own, with 7 other manufacturers making up the rest. 2025 is the largest year on record at $3,000, 2.6 times the $1,167 reported in 2019. Among otolaryngology clinicians in NC 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 76 payments — averaging $113.46 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Medtronic$7K
- Stryker$1K
- Intersect ENT, Inc.$504
- 3-d Matrix, Inc.$191
- Acclarent, Inc$176
- AstraZeneca$122
- plus $100 from 2 others
What the payments were for
- Consulting fees$1001%
- Travel & lodging$5,42263%
- Food & beverage$3,10136%
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 |
|---|---|---|
| Medtronic(2 entities) | 53 | $6,528 |
| Stryker | 11 | $1,002 |
| Intersect ENT, Inc. | 6 | $504 |
| 3-d Matrix, Inc. | 1 | $191 |
| Acclarent, Inc | 1 | $176 |
| AstraZeneca | 1 | $122 |
| Regeneron Healthcare Solutions, Inc. | 1 | $73 |
| Smith+Nephew | 2 | $27 |
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.
- FUSION$1,969
- STRAIGHTSHOT$921
- STEALTHSTATION S8 PLATFORM$451
- PROPEL$390
- TruDi Nav Cable$176
- XPRESS ENT DILATION SYSTEM$168
- CORE$149
- SWITCHPOINT INFINITY, ISUITE$149
- SONOPET IQ$149
- STRYKER NAV3I$149
- NSE - SONOPET$142
- N/A$131
- UNIVERSAL NEURO 3$126
- TEZSPIRE$122
- SCOPIS ENT$104
How this compares
$8,623 in reported general payments places this provider in the 90th percentile of 362 otolaryngology providers in North Carolina.
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 |
|---|---|---|
| Ipratropium Bromide | 62 | $1,260 |
| Fluticasone Propionate | 24 | $512 |
| Azelastine Hcl | 12 | $133 |
| Amoxicillin-Clavulanate PotassAmoxicillin/Potassium Clav | 13 | $131 |
| Methylprednisolone | 17 | $70 |
| Levofloxacin | 12 | $43 |
Paid to pharmacies, not to this prescriber.
Other otolaryngology in Durham
- David JangDurham$324K
- Feras AckallDurham$7K
- David KaylieDurham$7K
- Seth CohenDurham$6K
- Robert FerrisRaleigh$258K
- Adam ZanationHickory$227K
- Brent SeniorChapel Hill$91K
- Charles EbertChapel Hill$57K
- Adam CampbellWinston Salem$47K
- Harold PillsburyChapel Hill$42K
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.