Roberto Casal, MD
Pulmonary Disease · Houston, TXNPI 1619116167
Payments from drug & device makers
What this record shows
The money is spread across several categories — travel and lodging (28.9%), education and speaking fees — rather than concentrated in one kind of arrangement. 11 manufacturers reported payments, led by Intuitive Surgical at 47.7% of the total. Among pulmonary disease clinicians in TX with any reported payments, this total sits in the top 5% — high for the specialty, which is a reason to read the composition above rather than the number alone.
Across 165 payments — averaging $682.83 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Intuitive Surgical$54K
- Olympus Corporation Of The Americas$23K
- Siemens Medical Solutions USA, Inc.$22K
- Olympus Medical Systems Corporation$7K
- Gyrus ACMI, Inc.$3K
- Johnson & Johnson$1K
- plus $3K from 5 others
Across 16 payments — averaging $47,023 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.
- Siemens Medical Solutions USA, Inc.$648K
- Gyrus ACMI, Inc.$46K
- Concordia Laboratories Inc.$31K
- Ethicon Endo-surgery Inc.$23K
- Spiration, Inc.$4K
What the payments were for
- Consulting fees$14,69013%
- Speaking & faculty fees$30,46527%
- Travel & lodging$32,51429%
- Food & beverage$2,8743%
- Education$32,07528%
- Gifts$480%
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 |
|---|---|---|
| Intuitive Surgical | 93 | $53,688 |
| Olympus Corporation Of The Americas | 27 | $22,738 |
| Siemens Medical Solutions USA, Inc. | 16 | $22,032 |
| Olympus Medical Systems Corporation | 6 | $7,161 |
| Gyrus ACMI, Inc. | 5 | $2,860 |
| Johnson & Johnson | 5 | $1,167 |
| Olympus Corporation | 5 | $1,060 |
| Ethicon Endo-surgery Inc. | 3 | $987 |
| Spiration, Inc. | 2 | $880 |
| Olympus America Inc. | 2 | $74 |
| Medical Device Business Services, Inc. | 1 | $19 |
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.
- Da Vinci Surgical System$45,871
- Olympus EBUS Bronchoscopes$22,402
- Olympus Respiratory Accessories$22,402
- Olympus Bronchoscopes$21,340
- Olympus Capital Accessories$17,122
- ION$6,000
- EVIS EXERA$5,280
- Monarch Platform$1,167
- Neuwave$987
- Spiration Valve System$880
- Cios Spin$157
How this compares
$112,666 in reported general payments places this provider in the 95th percentile of 904 pulmonary disease 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 |
|---|---|---|
| Trelegy ElliptaFluticasone/Umeclidin/Vilanter | 20 | $15,593 |
Paid to pharmacies, not to this prescriber.
Other pulmonary disease in Houston
- Nicola HananiaHouston$1.3M
- Sandeep SahayHouston$378K
- Zeenat SafdarHouston$291K
- Howard HuangHouston$194K
- Brandy McKelvyHouston$168K
- Alexander StadnykHouston$158K
- Lisa KopasHouston$120K
- Sandeep GuptaHouston$118K
- Dileep PuppalaHouston$108K
- Phuongdung NguyenHouston$95K
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.