RxDoctor Payments Data

Rudrick Ledesma, MD

Nephrology · Tyler, TXNPI 1306125836

Payments from drug & device makers

$2,745in general payments, 2019–2025

Across 92 payments — averaging $29.83 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.

  • Amgen$428
  • Nxstage Medical, Inc.$409
  • Fresenius USA Marketing, Inc.$282
  • AstraZeneca$258
  • Novo Nordisk$176
  • Travere Therapeutics, Inc.$162
  • plus $1K from 14 others

What the payments were for

  • Food & beverage$2,70198%
  • Education$442%

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

19
20
21
22
23
24
25

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

$2,745 in reported general payments places this provider in the 55th percentile of 1,070 nephrology providers in Texas.

See all nephrology providers in Texas

Medicare billing

Part B allowed, 2024
$255,351
Medicare patients
635
Services billed
3,014

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

DrugClaimsCost to plans & patients
VelphoroSucroferric Oxyhydroxide56$149,712
JardianceEmpagliflozin114$97,095
FarxigaDapagliflozin Propanediol79$55,961
LokelmaSodium Zirconium Cyclosilicate44$55,104
AuryxiaFerric Citrate14$47,499
Sevelamer Carbonate155$30,537
Cinacalcet Hcl14$7,087
Midodrine Hcl41$5,281
Calcitriol147$1,645
Tamsulosin Hcl123$1,610
Clonidine12$1,402
Calcium Acetate11$1,311
Hydralazine Hcl125$1,142
Lisinopril223$1,068
Losartan Potassium152$1,067

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.

CompanyPaid to this providerPart D cost of their drugs
Fresenius USA Marketing, Inc.Velphoro$282$149,71256 claims
AstraZenecaFarxiga, Lokelma$258$111,065123 claims
Boehringer IngelheimJardiance$141$97,095114 claims
Akebia Therapeutics IncAuryxia$150$47,49914 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 55th percentile of 1,070 nephrology providers in Texas.

Other nephrology in Tyler

See the full list for Texas

Where these figures come from

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