Senthil Ramaiyah, MD
Nephrology · Flint, MINPI 1699968628
Payments from drug & device makers
What this record shows
The money is spread across several categories — speaking fees (39.5%), consulting fees and food and beverage — rather than concentrated in one kind of arrangement. Outset Medical Inc accounts for 85.5% of it on its own, with 26 other manufacturers making up the rest. Reporting peaked in 2023 at $8,796 and has fallen 54.3% since, to $4,022 in 2025. Among nephrology clinicians in MI with any reported payments, this total sits in the top 10% — high for the specialty, which is a reason to read the composition above rather than the number alone.
Across 143 payments — averaging $130.16 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Outset Medical Inc$16K
- Vifor Pharma, Inc.$410
- AstraZeneca$297
- Amgen$264
- Recor Medical Inc$203
- Otsuka America Pharmaceutical, Inc.$162
- plus $1K from 21 others
What the payments were for
- Consulting fees$6,15033%
- Speaking & faculty fees$7,35039%
- Travel & lodging$1,90110%
- Food & beverage$3,12817%
- Education$850%
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 |
|---|---|---|
| Outset Medical Inc | 15 | $15,914 |
| Vifor Pharma, Inc. | 18 | $410 |
| AstraZeneca(2 entities) | 15 | $297 |
| Amgen(2 entities) | 16 | $264 |
| Recor Medical Inc | 4 | $203 |
| Otsuka America Pharmaceutical, Inc. | 8 | $162 |
| Calliditas Therapeutics US Inc. | 7 | $130 |
| Fresenius USA Marketing, Inc. | 5 | $129 |
| Baxter Healthcare | 2 | $127 |
| Bayer | 5 | $115 |
| Akebia Therapeutics Inc | 9 | $112 |
| Travere Therapeutics, Inc. | 5 | $109 |
| OPKO Pharmaceuticals, LLC | 6 | $92 |
| Aurinia Pharma U.S., Inc. | 4 | $75 |
| Boehringer Ingelheim | 4 | $73 |
| Scpharmaceuticals Inc. | 4 | $68 |
| Novo Nordisk | 3 | $55 |
| Novartis | 2 | $54 |
| Cormedix Inc. | 2 | $50 |
| Shire North American Group Inc | 2 | $36 |
| Sanofi | 1 | $34 |
| Mallinckrodt Enterprises LLC | 1 | $22 |
| Arbor Pharmaceuticals, Inc. | 1 | $19 |
| Daiichi Sankyo Inc. | 1 | $19 |
| AMAG Pharmaceuticals, Inc. | 1 | $16 |
| Takeda Pharmaceuticals U.S.A., Inc. | 1 | $15 |
| GSK | 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.
- Renal - PD$102
How this compares
$18,613 in reported general payments places this provider in the 90th percentile of 325 nephrology providers in Michigan.
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 |
|---|---|---|
| MounjaroTirzepatide | 260 | $346,262 |
| JardianceEmpagliflozin | 311 | $336,334 |
| OzempicSemaglutide | 228 | $311,931 |
| FarxigaDapagliflozin Propanediol | 125 | $110,638 |
| VelphoroSucroferric Oxyhydroxide | 18 | $51,732 |
| ProcritEpoetin Alfa | 20 | $22,737 |
| TrulicityDulaglutide | 13 | $20,946 |
| LokelmaSodium Zirconium Cyclosilicate | 29 | $19,764 |
| VeltassaPatiromer Calcium Sorbitex | 14 | $14,501 |
| Sevelamer Carbonate | 72 | $13,381 |
| EliquisApixaban | 14 | $12,356 |
| Olmesartan-Amlodipine-HctzOlmesartan/Amlodipin/Hcthiazid | 62 | $7,266 |
| Calcium Acetate | 47 | $3,659 |
| ProsolParenteral Amino Acid 20% No.1 | 21 | $3,582 |
| Amlodipine-OlmesartanAmlodipine Bes/Olmesartan Med | 47 | $2,974 |
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 |
|---|---|---|
| Boehringer IngelheimJardiance | $73 | $336,334311 claims |
| Novo NordiskOzempic | $55 | $311,931228 claims |
| AstraZenecaFarxiga, Lokelma | $297 | $130,402154 claims |
| Fresenius USA Marketing, Inc.Velphoro | $129 | $51,73218 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 90th percentile of 325 nephrology providers in Michigan.
Other nephrology in Flint
- Alexander YevzlinAnn Arbor$1.1M
- Muwaffaq SalamehBay City$164K
- Laura MarianiAnn Arbor$150K
- Crystal Gardner-MartinLivonia$140K
- Katherine KwonSaint Joseph$111K
- Anatole BesarabDetroit$102K
- Richard CrossSaint Clair Shores$96K
- Kausik UmanathDetroit$85K
- Joel TopfRoseville$79K
- Matthias KretzlerAnn Arbor$70K
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.