Roy Koga, MD
Family Medicine · Hilo, HINPI 1164511309
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 99.7% of the total across 923 separate payments, which is the pattern of a clinician who attends manufacturer presentations rather than one with a consulting arrangement. It is spread thinly across 27 manufacturers, the largest accounting for just 23.1% — the pattern of someone who eats at a lot of different presentations. Reporting peaked in 2021 at $3,924 and has fallen 71.0% since, to $1,138 in 2025. Among family medicine clinicians in HI 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 923 payments — averaging $21.30 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- AstraZeneca$5K
- Novo Nordisk$2K
- Amarin Pharma, Inc.$1K
- Amgen$1K
- Lilly USA, LLC$1K
- Pfizer$1K
- plus $8K from 21 others
What the payments were for
- Food & beverage$19,610100%
- Education$500%
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 |
|---|---|---|
| AstraZeneca | 152 | $4,541 |
| Novo Nordisk | 118 | $2,131 |
| Amarin Pharma, Inc. | 72 | $1,438 |
| Amgen(2 entities) | 51 | $1,430 |
| Lilly USA, LLC | 59 | $1,305 |
| Pfizer | 75 | $1,235 |
| Bayer | 38 | $997 |
| Johnson & Johnson | 38 | $915 |
| Kowa Pharmaceuticals America, Inc. | 61 | $817 |
| Boehringer Ingelheim | 34 | $719 |
| AbbVie(2 entities) | 42 | $710 |
| Sanofi-aventis U.S. LLC | 37 | $654 |
| Corcept Therapeutics | 23 | $590 |
| Merck | 23 | $468 |
| Biohaven Pharmaceuticals, Inc. | 18 | $278 |
| Biohaven Pharmaceutical Holding Company Ltd. | 27 | $250 |
| Arbor Pharmaceuticals, Inc. | 13 | $224 |
| ITI, Inc. (d/b/a Intra-cellular Therapies, Inc.) | 7 | $217 |
| Takeda Pharmaceuticals U.S.A., Inc. | 13 | $175 |
| Eisai Inc. | 8 | $159 |
| Esperion Therapeutics, Inc. | 6 | $131 |
| Dexcom, Inc. | 1 | $94 |
| Otsuka America Pharmaceutical, Inc. | 1 | $61 |
| GSK | 3 | $55 |
| Boston Scientific | 1 | $37 |
| E.r. Squibb & Sons, L.L.C. | 1 | $15 |
| Novartis | 1 | $13 |
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
$19,660 in reported general payments places this provider in the 95th percentile of 376 family medicine providers in Hawaii.
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 |
|---|---|---|
| FarxigaDapagliflozin Propanediol | 254 | $227,021 |
| OzempicSemaglutide | 90 | $101,444 |
| Soliqua 100-33Insulin Glargine/Lixisenatide | 85 | $82,800 |
| JardianceEmpagliflozin | 74 | $73,498 |
| MounjaroTirzepatide | 60 | $63,341 |
| EliquisApixaban | 40 | $44,248 |
| TrulicityDulaglutide | 16 | $33,007 |
| Breztri AerosphereBudesonide/Glycopyr/Formoterol | 29 | $25,629 |
| InvokanaCanagliflozin | 14 | $23,354 |
| KerendiaFinerenone | 23 | $22,641 |
| VascepaIcosapent Ethyl | 31 | $16,101 |
| JanumetSitagliptin Phos/Metformin Hcl | 19 | $15,676 |
| XareltoRivaroxaban | 22 | $12,164 |
| Rosuvastatin Calcium | 237 | $9,677 |
| Atorvastatin Calcium | 342 | $9,028 |
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 |
|---|---|---|
| AstraZenecaFarxiga, Breztri Aerosphere, Symbicort | $4,541 | $259,608301 claims |
| Novo NordiskOzempic | $2,131 | $101,44490 claims |
| Lilly USA, LLCMounjaro, Trulicity | $1,305 | $96,34876 claims |
| Sanofi-aventis U.S. LLCSoliqua 100-33 | $654 | $82,80085 claims |
| Boehringer IngelheimJardiance | $719 | $73,49874 claims |
| PfizerEliquis | $1,235 | $44,24840 claims |
| Johnson & JohnsonInvokana, Xarelto | $915 | $35,51836 claims |
| BayerKerendia | $997 | $22,64123 claims |
| MerckJanumet | $468 | $15,67619 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 95th percentile of 376 family medicine providers in Hawaii.
Other family medicine in Hilo
- Buddy FesterlingHilo$20K
- Douglas OlsenHilo$13K
- Kara OkaharaHilo$9K
- Charles SonidoHilo$8K
- Matthew DykemaHilo$8K
- Richard Lee-ChingHilo$3K
- Gina Marie SalcedoHilo$3K
- Brian StolleyKihei$126K
- Vicente RamoHonolulu$34K
- Edward AlqueroWaipahu$24K
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.