Robert Cristel, MD
Otolaryngology · O Fallon, MONPI 1568999001
Payments from drug & device makers
What this record shows
This record is dominated by food and beverage: $4,974 of the $7,317 with a category attached, or 68.0%. 13 manufacturers reported payments, led by Medical Device Business Services, Inc. at 32.0% of the total. 2025 is the largest year on record at $2,840, 2.9 times the $974 reported in 2022. Among otolaryngology clinicians in MO 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 160 payments — averaging $45.73 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Medical Device Business Services, Inc.$2K
- Stryker$2K
- Organogenesis Inc.$1K
- Sanofi$389
- GSK$343
- Aerin Medical Inc.$254
- plus $635 from 7 others
What the payments were for
- Travel & lodging$2,34432%
- Food & beverage$4,97468%
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 |
|---|---|---|
| Medical Device Business Services, Inc. | 2 | $2,344 |
| Stryker | 73 | $2,060 |
| Organogenesis Inc. | 49 | $1,291 |
| Sanofi | 9 | $389 |
| GSK | 9 | $343 |
| Aerin Medical Inc. | 5 | $254 |
| Regeneron Healthcare Solutions, Inc. | 5 | $230 |
| Galderma Laboratories, L.p. | 1 | $125 |
| Kls-martin L.p. | 1 | $120 |
| Revance Therapeutics, Inc. | 3 | $79 |
| Hologic Sales And Service, LLC | 1 | $34 |
| Integra Lifesciences Corporation | 1 | $25 |
| Elite Orthopedics, LLC | 1 | $22 |
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.
- SCOPIS ENT$546
- DUPIXENT$352
- SIMPLIMAX$279
- NA$236
- PuraPly$234
- PURAPLY WOUND MATRIX$234
- NUCALA$233
- AUDION ET DILATION SYSTEM$167
- CLARIFIX$167
- XPRESS LOPROFILE$167
- LATERA$156
- VIVAER STYLUS$131
- RHINAER STYLUS$131
- XPRESS ENT DILATION SYSTEM$128
- SMARTLOCK$118
How this compares
$7,317 in reported general payments places this provider in the 90th percentile of 210 otolaryngology providers in Missouri.
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 |
|---|---|---|
| Ofloxacin | 25 | $871 |
| Hydrocodone-AcetaminophenHydrocodone/Acetaminophen | 131 | $633 |
| Methylprednisolone | 75 | $495 |
| Cephalexin | 110 | $391 |
| Ipratropium Bromide | 14 | $308 |
| Pantoprazole Sodium | 19 | $218 |
| Amoxicillin-Clavulanate PotassAmoxicillin/Potassium Clav | 24 | $193 |
| Ondansetron Hcl | 13 | $82 |
| Famotidine | 14 | $48 |
| Doxycycline Hyclate | 17 | $44 |
| Triazolam | 12 | $30 |
Paid to pharmacies, not to this prescriber.
Other otolaryngology in O Fallon
- Talon ManingasJoplin$314K
- Ryan JacksonSaint Louis$284K
- Ravindra UppaluriSaint Louis$168K
- James GouldFestus$143K
- John SchneiderSaint Louis$74K
- Amit WaliaSaint Louis$21K
- Bharat PanugantiSaint Louis$19K
- Jeffrey SharonSt. Louis$18K
- Kelvin WallsLees Summit$14K
- Cristine Klatt-CromwellSaint Louis$13K
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.