Ralph Ierardi, MD
Vascular Surgery · Winter Park, FLNPI 1477648160
Payments from drug & device makers
What this record shows
This record is dominated by food and beverage: $6,460 of the $7,353 with a category attached, or 87.8%. 28 manufacturers reported payments, led by Penumbra, Inc. at 25.1% of the total. Reporting peaked in 2021 at $2,336 and has fallen 65.7% since, to $801 in 2025. That places this record below the midpoint for vascular surgery clinicians in FL, where the typical reported total is $6,364.
Across 146 payments — averaging $50.37 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Penumbra, Inc.$2K
- W. L. Gore & Associates, Inc.$1K
- Medtronic$716
- Johnson & Johnson$335
- Endologix LLC$327
- Silk Road Medical, Inc.$310
- plus $2K from 22 others
Across 9 payments — averaging $1078.80 each. Payments tied to a research study. These frequently flow through the physician to a hospital or research institution rather than to the physician personally.
- Endologix LLC$10K
What the payments were for
- Travel & lodging$84812%
- Food & beverage$6,46088%
- Education$461%
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 |
|---|---|---|
| Penumbra, Inc. | 10 | $1,846 |
| W. L. Gore & Associates, Inc. | 32 | $1,363 |
| Medtronic(2 entities) | 12 | $716 |
| Johnson & Johnson | 9 | $335 |
| Endologix LLC | 5 | $327 |
| Silk Road Medical, Inc. | 8 | $310 |
| Cook Medical LLC | 16 | $303 |
| Bard Peripheral Vascular, Inc. | 2 | $286 |
| Cvrx, Inc. | 5 | $266 |
| Abbott | 5 | $259 |
| Boston Scientific | 5 | $215 |
| Angiodynamics, Inc. | 3 | $188 |
| Inari Medical, Inc. | 8 | $174 |
| Cardiovascular Systems Inc. | 3 | $157 |
| KCI USA, Inc. | 1 | $125 |
| Smith+Nephew | 5 | $101 |
| Stryker | 2 | $90 |
| Lemaitre Vascular, Inc. | 3 | $43 |
| Tactile Systems Technology Inc | 2 | $41 |
| Lifenet Health | 1 | $35 |
| Kerecis Limited | 2 | $34 |
| Aroa Biosurgery Incorporated | 1 | $32 |
| Bolton Medical Inc | 1 | $24 |
| Artivion, Inc. | 1 | $19 |
| Terumo Medical Corporation | 1 | $18 |
| Flowphysix Inc | 1 | $16 |
| Solventum Corporation | 1 | $16 |
| Cashflow Solutions, LLC | 1 | $15 |
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.
- Indigo System$1,744
- GORE VIABAHN VBX Balloon Expandable Endo$318
- ENDURANT IIS$150
- Barostim Neo System$150
- VIABAHN Endoprosthesis$149
- XARELTO$147
- HawkOne$143
- VIABAHN VBX Balloon Expandable Endoprosthesis$142
- CHOCOLATE PTA BALLOON CATHETER$134
- EXCLUDER AAA Endoprosthesis$129
- MitraClip$129
- PREVENA$125
- VAC VERAFLO$125
- Peripheral Orbital Atherectomy System$115
- Zenith Spiral-Z$112
- Alto Abdominal Stent Graft System$105
How this compares
$7,353 in reported general payments places this provider in the 50th percentile of 385 vascular surgery providers in Florida.
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 | 33 | $27,682 |
| ClopidogrelClopidogrel Bisulfate | 65 | $557 |
Paid to pharmacies, not to this prescriber.
Other vascular surgery in Winter Park
- Samuel TapperStuart$1.3M
- Mariano ArosemenaBradenton$472K
- Manuel Perez IzquierdoOrlando$302K
- Erin MooreJacksonville$300K
- Rajesh MalikNaples$237K
- Charles BaileyTampa$162K
- Joseph WasselleMelbourne$161K
- Joseph RicottaDelray Beach$156K
- Murray ShamesTampa$144K
- K Dean ArnaoutakisTampa$115K
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.