Ryan Bierle, PA
Surgical · San Antonio, TXNPI 1578849733
Payments from drug & device makers
Across 15 payments — averaging $91.13 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- AstraZeneca$250
- Actelion Pharmaceuticals US, Inc.$248
- Chiesi USA, Inc.$170
- Grifols USA, LLC$158
- Stryker$153
- La Jolla Pharmaceutical Company$118
- plus $270 from 5 others
What the payments were for
- Food & beverage$1,31796%
- Gifts$504%
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(2 entities) | 2 | $250 |
| Actelion Pharmaceuticals US, Inc. | 2 | $248 |
| Chiesi USA, Inc. | 3 | $170 |
| Grifols USA, LLC | 1 | $158 |
| Stryker | 1 | $153 |
| La Jolla Pharmaceutical Company | 1 | $118 |
| Vapotherm Inc | 1 | $101 |
| Fisher & Paykel Healthcare Inc | 1 | $78 |
| Teleflex LLC | 1 | $64 |
| Brainscope Company, Inc. | 1 | $16 |
| Johnson & Johnson | 1 | $12 |
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
$1,367 in reported general payments places this provider in the 75th percentile of 804 surgical 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 |
|---|---|---|
| Ibuprofen | 15 | $46 |
Paid to pharmacies, not to this prescriber.
Other surgical in San Antonio
- Krista GranthamSan Antonio$187K
- Karen AdamsSan Antonio$9K
- Melinda GonzalezSan Antonio$7K
- James HoustonSan Antonio$4K
- Courtney DunavantAustin$389K
- Gerald BuchertBellaire$148K
- Gilberto SaenzGeorgetown$70K
- Andrea McNielHumble$48K
- Marilyn ShookHouston$46K
- Henry KinnebrewAustin$40K
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.