Samantha Ralstin, DPM
Foot & Ankle Surgery · Mesquite, TXNPI 1679033062
Payments from drug & device makers
What this record shows
The money is spread across several categories — travel and lodging (40.8%), food and beverage and education — rather than concentrated in one kind of arrangement. 18 manufacturers reported payments, led by Synthes GmbH at 34.2% of the total. 2025 is the largest year on record at $4,121, more than ten times the $249 reported in 2019.
Across 72 payments — averaging $147.00 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Synthes GmbH$4K
- Stryker$3K
- Pylant Medical$1K
- Smith+Nephew$633
- Anika Therapeutics, Inc.$570
- Evolution Surgical, Inc$243
- plus $929 from 12 others
What the payments were for
- Consulting fees$1,0009%
- Speaking & faculty fees$1,0009%
- Travel & lodging$4,31941%
- Food & beverage$3,06529%
- Education$1,20011%
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 |
|---|---|---|
| Synthes GmbH | 7 | $3,620 |
| Stryker | 29 | $3,389 |
| Pylant Medical | 1 | $1,200 |
| Smith+Nephew | 16 | $633 |
| Anika Therapeutics, Inc. | 1 | $570 |
| Evolution Surgical, Inc | 2 | $243 |
| Bioventus LLC | 2 | $174 |
| Organogenesis Inc. | 3 | $163 |
| Bone Support Inc. | 1 | $150 |
| Vertex | 1 | $125 |
| Johnson & Johnson | 1 | $103 |
| Integra Lifesciences Corporation | 1 | $71 |
| Mimedx Group, Inc. | 2 | $45 |
| Trimed, Inc. | 1 | $31 |
| KCI USA, Inc. | 1 | $19 |
| GSK | 1 | $18 |
| Kerecis Limited | 1 | $16 |
| Medtronic | 1 | $14 |
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.
- PRIME SERIES$1,324
- PROstep$952
- TACTOSET$570
- CERAMENTBONE VOID FILLER$150
- Exogen Ultrasound Bone Healing System$144
- Grafix$133
- VERSAJET II$125
- JOURNAVX$125
- INFINITY$124
- Grafix PRIME$122
- Grafix CORE$122
- Grafix XC$122
- Grafix PL PRIME$122
- Stravix$122
- Puraply Antimicrobial$120
- ORTHOLOC 2 LAPIFUSE$117
- Vivigen MIS Delivery System$103
- Fibulink$103
- HAMMERLOCK$103
How this compares
$10,584 in reported general payments places this provider in the 75th percentile of 684 foot & ankle surgery 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 |
|---|---|---|
| Hydrocodone-AcetaminophenHydrocodone/Acetaminophen | 12 | $128 |
| Meloxicam | 18 | $40 |
Paid to pharmacies, not to this prescriber.
Other foot & ankle surgery in Mesquite
- William McGarveyKaty$3.5M
- Eugene CurryDallas$3.1M
- Graham HamiltonEdinburg$2.1M
- Mark DaltonAustin$1.9M
- Kevin VarnerHouston$1.1M
- Paul KimDallas$928K
- Sherman NaglerHouston$602K
- John EarlyDallas$553K
- Michael DowneySouthlake$475K
- Abdul NurudeenHouston$404K
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.