Rama Palwai, MD
Rheumatology · Spring, TXNPI 1689610115
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 97.0% of the total across 169 separate payments, which is the pattern of a clinician who attends manufacturer presentations rather than one with a consulting arrangement. 23 manufacturers reported payments, led by Amgen at 24.9% of the total. Reporting peaked in 2023 at $940 and has fallen 89.9% since, to $95 in 2024. That places this record below the midpoint for rheumatology clinicians in TX, where the typical reported total is $3,779.
Across 169 payments — averaging $21.44 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Amgen$903
- AbbVie$715
- Johnson & Johnson$348
- Lilly USA, LLC$295
- UCB, Inc.$285
- Boehringer Ingelheim$156
- plus $922 from 17 others
Across 7 payments — averaging $16,742 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.
- Eli Lilly$60K
- UCB SA$38K
- Amgen$14K
- E.r. Squibb & Sons, L.L.C.$5K
What the payments were for
- Food & beverage$3,51597%
- Education$1093%
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 |
|---|---|---|
| Amgen(2 entities) | 40 | $903 |
| AbbVie | 36 | $715 |
| Johnson & Johnson | 18 | $348 |
| Lilly USA, LLC | 15 | $295 |
| UCB, Inc. | 13 | $285 |
| Boehringer Ingelheim | 7 | $156 |
| Novartis | 8 | $153 |
| Janssen Scientific Affairs, LLC | 1 | $110 |
| Sanofi | 1 | $100 |
| AstraZeneca | 6 | $99 |
| GSK | 5 | $90 |
| Genentech USA, Inc. | 2 | $77 |
| Mallinckrodt Hospital Products Inc. | 3 | $59 |
| Pfizer | 4 | $57 |
| Radius Health, Inc. | 2 | $28 |
| Abbott | 1 | $24 |
| Aurinia Pharma U.S., Inc. | 1 | $24 |
| Fresenius Kabi USA, LLC | 1 | $23 |
| Ultragenyx Pharmaceutical Inc. | 1 | $21 |
| Oxford Immunotec USA Inc | 1 | $19 |
| E.r. Squibb & Sons, L.L.C. | 1 | $16 |
| Merck | 1 | $12 |
| Cumberland Pharmaceuticals, 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.
How this compares
$3,624 in reported general payments places this provider in the 45th percentile of 512 rheumatology providers in Texas.
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 |
|---|---|---|
| Humira(Cf) PenAdalimumab | 13 | $87,219 |
| Teriparatide | 13 | $22,177 |
| MethotrexateMethotrexate Sodium | 152 | $4,194 |
| Hydroxychloroquine Sulfate | 96 | $3,048 |
| Sulfasalazine DrSulfasalazine | 57 | $2,093 |
| Sulfasalazine | 55 | $1,297 |
| Pilocarpine Hcl | 12 | $1,186 |
| Gabapentin | 68 | $893 |
| Prednisone | 115 | $538 |
| Duloxetine Hcl | 20 | $436 |
| Leflunomide | 29 | $400 |
| Tramadol Hcl | 71 | $376 |
| Folic Acid | 34 | $369 |
| Ibandronate Sodium | 12 | $300 |
| Azathioprine | 18 | $272 |
Paid to pharmacies, not to this prescriber.
Other rheumatology in Spring
- Gabriela BahrSpring$65K
- John CushDallas$3.7M
- Sanjay ChabraEl Paso$3.3M
- Dhiman BasuColleyville$1.8M
- Frank WellborneNew Braunfels$1.4M
- Christopher ParkerWest Lake Hills$1.4M
- Pendleton WickershamSan Antonio$954K
- Henry TownsendPlano$738K
- Zoran KurepaDallas$483K
- Giovanni GeslaniDallas$415K
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.