Robin Spiering, MD
Internal Medicine · El Cajon, CANPI 1467458729
Payments from drug & device makers
Across 487 payments — averaging $22.75 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- GSK$2K
- AstraZeneca$1K
- AbbVie$1K
- Novo Nordisk$842
- Lilly USA, LLC$789
- Boehringer Ingelheim$719
- plus $5K from 43 others
What the payments were for
- Food & beverage$11,054100%
- Education$240%
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.
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
$11,078 in reported general payments places this provider in the 90th percentile of 13,581 internal medicine providers in California.
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 |
|---|---|---|
| StelaraUstekinumab | 11 | $355,885 |
| EliquisApixaban | 200 | $223,447 |
| FarxigaDapagliflozin Propanediol | 138 | $158,608 |
| OzempicSemaglutide | 110 | $157,449 |
| Trelegy ElliptaFluticasone/Umeclidin/Vilanter | 137 | $130,151 |
| JardianceEmpagliflozin | 65 | $87,797 |
| MounjaroTirzepatide | 45 | $54,495 |
| VascepaIcosapent Ethyl | 80 | $53,693 |
| TrulicityDulaglutide | 42 | $49,137 |
| XareltoRivaroxaban | 40 | $42,978 |
| RybelsusSemaglutide | 18 | $40,647 |
| EntrestoSacubitril/Valsartan | 30 | $35,287 |
| MyrbetriqMirabegron | 52 | $34,210 |
| Anoro ElliptaUmeclidinium Brm/Vilanterol Tr | 36 | $23,096 |
| JanuviaSitagliptin Phosphate | 11 | $18,113 |
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 |
|---|---|---|
| Johnson & JohnsonStelara, Xarelto | $69 | $398,86351 claims |
| PfizerEliquis, Nurtec Odt | $571 | $240,071211 claims |
| Novo NordiskOzempic, Rybelsus | $842 | $198,096128 claims |
| GSKTrelegy Ellipta, Anoro Ellipta, Breo Ellipta | $1,512 | $168,257197 claims |
| AstraZenecaFarxiga, Symbicort | $1,406 | $162,553149 claims |
| Boehringer IngelheimJardiance, Spiriva Respimat, Stiolto Respimat | $719 | $109,65293 claims |
| Lilly USA, LLCMounjaro, Trulicity | $789 | $103,63287 claims |
| NovartisEntresto | $160 | $35,28730 claims |
| Astellas Pharma US IncMyrbetriq | $60 | $34,21052 claims |
| MerckJanuvia | $366 | $18,11311 claims |
| Sumitomo Pharma America, Inc.Gemtesa | $21 | $14,56313 claims |
| Sanofi-aventis U.S. LLCSoliqua 100-33 | $305 | $10,94513 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 13,581 internal medicine providers in California.
Other internal medicine in El Cajon
- Andrew ChengSouth San Francisco$55.1M
- Joel NeutelTustin$34.9M
- Donald BrandonSan Diego$34M
- William TownerLos Angeles$27.4M
- Rahul AggarwalSan Francisco$24M
- Masoud AzizadNorthridge$21.1M
- Helen StaceyWalnut Creek$20.4M
- Rohit Loombala Jolla$15.1M
- Zeid KayaliColton$14.2M
- Alexandra DrakakiSanta Monica$14.2M
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.