Ralph Aquadro, MD
Internal Medicine · Florence, ALNPI 1396797288
Payments from drug & device makers
Across 550 payments — averaging $16.86 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Novo Nordisk$2K
- AstraZeneca$1K
- Pfizer$883
- Lilly USA, LLC$785
- GSK$785
- Boehringer Ingelheim$432
- plus $3K from 24 others
What the payments were for
- Food & beverage$9,275100%
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 | 102 | $1,950 |
| AstraZeneca | 72 | $1,372 |
| Pfizer | 62 | $883 |
| Lilly USA, LLC | 47 | $785 |
| GSK | 48 | $785 |
| Boehringer Ingelheim | 28 | $432 |
| AbbVie(2 entities) | 31 | $417 |
| Bayer | 22 | $408 |
| Amgen(2 entities) | 28 | $360 |
| Amarin Pharma, Inc. | 17 | $289 |
| Johnson & Johnson | 16 | $232 |
| Exact Sciences | 12 | $218 |
| Shield Therapeutics Inc | 9 | $191 |
| Takeda Pharmaceuticals U.S.A., Inc. | 12 | $163 |
| Merck | 9 | $139 |
| Revance Therapeutics, Inc. | 3 | $110 |
| Biohaven Pharmaceutical Holding Company Ltd. | 5 | $98 |
| Esperion Therapeutics, Inc. | 5 | $84 |
| Bausch Health US, LLC | 4 | $80 |
| Kowa Pharmaceuticals America, Inc. | 4 | $54 |
| E.r. Squibb & Sons, L.L.C. | 3 | $34 |
| Supernus Pharmaceuticals, Inc. | 2 | $30 |
| Vivus LLC | 2 | $24 |
| Corcept Therapeutics | 1 | $23 |
| Biogen | 1 | $22 |
| Kyowa Kirin, Inc. | 1 | $20 |
| Inspire Medical Systems, Inc. | 1 | $18 |
| Mentor Worldwide LLC | 1 | $18 |
| Novartis | 1 | $18 |
| Sumitomo Pharma America, Inc. | 1 | $16 |
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.
- Ozempic$220
- AIRSUPRA$114
- TRELEGY ELLIPTA$100
How this compares
$9,275 in reported general payments places this provider in the 90th percentile of 1,533 internal medicine providers in Alabama.
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 |
|---|---|---|
| EliquisApixaban | 305 | $217,823 |
| JardianceEmpagliflozin | 181 | $136,095 |
| FarxigaDapagliflozin Propanediol | 126 | $104,967 |
| OzempicSemaglutide | 71 | $81,630 |
| MounjaroTirzepatide | 54 | $73,299 |
| XareltoRivaroxaban | 27 | $22,122 |
| Toujeo SolostarInsulin Glargine,hum.Rec.Anlog | 14 | $15,169 |
| Tresiba Flextouch U-200Insulin Degludec | 20 | $13,267 |
| Trelegy ElliptaFluticasone/Umeclidin/Vilanter | 17 | $10,582 |
| Breo ElliptaFluticasone/Vilanterol | 16 | $9,119 |
| Omeprazole | 494 | $6,781 |
| Colesevelam Hcl | 13 | $6,314 |
| Atorvastatin Calcium | 443 | $5,887 |
| Anoro ElliptaUmeclidinium Brm/Vilanterol Tr | 12 | $5,557 |
| Ezetimibe | 114 | $5,032 |
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 |
|---|---|---|
| PfizerEliquis | $883 | $217,823305 claims |
| Boehringer IngelheimJardiance | $432 | $136,095181 claims |
| AstraZenecaFarxiga | $1,372 | $104,967126 claims |
| Novo NordiskOzempic | $1,950 | $81,63071 claims |
| Lilly USA, LLCMounjaro | $785 | $73,29954 claims |
| GSKTrelegy Ellipta, Breo Ellipta, Anoro Ellipta | $785 | $25,25745 claims |
| Johnson & JohnsonXarelto | $232 | $22,12227 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 1,533 internal medicine providers in Alabama.
Other internal medicine in Florence
- Harry StuddardMobile$12.9M
- Almena FreeAnniston$12.7M
- Hayes WilliamsVestavia$10.4M
- David DeatkineBirmingham$8M
- James SullivanBirmingham$6M
- Ramy TomaBirmingham$5.1M
- Barry McLeanHomewood$4M
- William KirbyBirmingham$2.3M
- Saadat AnsariHuntsville$2.1M
- Gregory FlippoTrussville$1.6M
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.