Romana Kleinguenther, MD
Neurology · San Antonio, TXNPI 1235224379
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 100.0% of the total across 53 separate payments, which is the pattern of a clinician who attends manufacturer presentations rather than one with a consulting arrangement. 10 manufacturers reported payments, led by UCB, Inc. at 40.0% of the total. 2025 is the largest year on record at $675, 8.6 times the $79 reported in 2022. That places this record below the midpoint for neurology clinicians in TX, where the typical reported total is $2,170.
Across 53 payments — averaging $25.32 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- UCB, Inc.$537
- Neurelis, Inc.$280
- SK Life Science, Inc.$152
- Jazz Pharmaceuticals Inc.$122
- Neurocrine Biosciences, Inc.$94
- Aucta Pharmaceuticals, Inc.$62
- plus $96 from 4 others
What the payments were for
- Food & beverage$1,342100%
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 |
|---|---|---|
| UCB, Inc. | 20 | $537 |
| Neurelis, Inc. | 9 | $280 |
| SK Life Science, Inc. | 7 | $152 |
| Jazz Pharmaceuticals Inc. | 4 | $122 |
| Neurocrine Biosciences, Inc. | 3 | $94 |
| Aucta Pharmaceuticals, Inc. | 6 | $62 |
| Livanova USA, Inc. | 1 | $33 |
| Lundbeck LLC | 1 | $25 |
| Alnylam Pharmaceuticals Inc. | 1 | $25 |
| Teva Pharmaceuticals USA, Inc. | 1 | $13 |
How this compares
$1,342 in reported general payments places this provider in the 40th percentile of 1,246 neurology 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 |
|---|---|---|
| Aimovig AutoinjectorErenumab-Aooe | 26 | $27,944 |
| Emgality PenGalcanezumab-Gnlm | 13 | $12,875 |
| Oxcarbazepine | 62 | $5,603 |
| Levetiracetam | 102 | $3,219 |
| Carbamazepine ErCarbamazepine | 19 | $2,779 |
| Lacosamide | 29 | $2,549 |
| Risperidone OdtRisperidone | 12 | $1,886 |
| Gabapentin | 74 | $1,371 |
| Topiramate | 126 | $1,341 |
| Primidone | 35 | $1,018 |
| Phenytoin Sodium Extended | 22 | $753 |
| Divalproex Sodium | 50 | $627 |
| Scopolamine | 11 | $588 |
| Carbidopa-Levodopa ErCarbidopa/Levodopa | 14 | $468 |
| Carbidopa-LevodopaCarbidopa/Levodopa | 44 | $459 |
Paid to pharmacies, not to this prescriber.
Other neurology in San Antonio
- Ann BassSan Antonio$1.7M
- Santiago RestrepoSan Antonio$532K
- Juan Ramirez CastanedaSan Antonio$456K
- Eleni VaouSan Antonio$236K
- Eric PappertSan Antonio$166K
- Arash SalardiniSan Antonio$125K
- William OndoHouston$1.4M
- Nirav PavasiaDallas$1.4M
- Mirla AvilaLubbock$1.3M
- Michael SoileauGeorgetown$1.2M
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.