Shanon Custer, MD
Internal Medicine · Hays, KSNPI 1902870637
Payments from drug & device makers
Across 313 payments — averaging $15.28 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Novo Nordisk$730
- Sunovion Pharmaceuticals Inc.$526
- Pfizer$385
- Boehringer Ingelheim$334
- Amgen$329
- AstraZeneca$306
- plus $2K from 30 others
What the payments were for
- Food & beverage$4,68398%
- Education$1002%
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 |
|---|---|---|
| Novo Nordisk | 47 | $730 |
| Sunovion Pharmaceuticals Inc. | 44 | $526 |
| Pfizer | 30 | $385 |
| Boehringer Ingelheim | 22 | $334 |
| Amgen | 20 | $329 |
| AstraZeneca | 20 | $306 |
| Sanofi-aventis U.S. LLC | 21 | $306 |
| Astellas Pharma US Inc | 11 | $228 |
| Lilly USA, LLC | 14 | $196 |
| Mylan Specialty L.p. | 11 | $181 |
| Dexcom, Inc. | 8 | $167 |
| Merck | 8 | $124 |
| AbbVie(2 entities) | 7 | $122 |
| GSK | 6 | $93 |
| Novartis | 5 | $88 |
| Bayer | 5 | $80 |
| Insulet Corporation | 3 | $65 |
| Cequr Corporation | 2 | $51 |
| Johnson & Johnson | 4 | $49 |
| Xeris Pharmaceuticals, Inc. | 2 | $42 |
| Regeneron Healthcare Solutions, Inc. | 2 | $39 |
| Daiichi Sankyo Inc. | 3 | $38 |
| Sanofi Pasteur Inc. | 2 | $34 |
| Sumitomo Pharma America, Inc. | 2 | $34 |
| Alnylam Pharmaceuticals Inc. | 1 | $32 |
| Apellis Pharmaceuticals, Inc. | 1 | $32 |
| Biohaven Pharmaceutical Holding Company Ltd. | 2 | $26 |
| E.r. Squibb & Sons, L.L.C. | 2 | $25 |
| Abbott | 1 | $20 |
| Genentech USA, Inc. | 1 | $16 |
| Mallinckrodt Hospital Products Inc. | 1 | $16 |
| Exact Sciences | 1 | $15 |
| Boston Scientific | 1 | $14 |
| Otsuka America Pharmaceutical, Inc. | 1 | $14 |
| Neurelis, Inc. | 1 | $14 |
| Collegium Pharmaceutical, Inc. | 1 | $12 |
How this compares
$4,783 in reported general payments places this provider in the 90th percentile of 705 internal medicine providers in Kansas.
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 |
|---|---|---|
| EliquisApixaban | 248 | $145,178 |
| MounjaroTirzepatide | 87 | $89,623 |
| OzempicSemaglutide | 83 | $88,421 |
| XareltoRivaroxaban | 136 | $85,982 |
| JardianceEmpagliflozin | 67 | $52,878 |
| JanuviaSitagliptin Phosphate | 78 | $50,107 |
| MyrbetriqMirabegron | 114 | $47,132 |
| Tresiba Flextouch U-200Insulin Degludec | 59 | $39,626 |
| Tresiba Flextouch U-100Insulin Degludec | 69 | $36,252 |
| TrulicityDulaglutide | 27 | $30,445 |
| RybelsusSemaglutide | 23 | $27,330 |
| FarxigaDapagliflozin Propanediol | 15 | $16,014 |
| Fiasp FlextouchInsulin Aspart (Niacinamide) | 15 | $11,966 |
| LinzessLinaclotide | 19 | $10,500 |
| Potassium Chloride | 423 | $9,719 |
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 |
|---|---|---|
| PfizerEliquis, Premarin | $385 | $153,241275 claims |
| Lilly USA, LLCMounjaro, Trulicity | $196 | $120,068114 claims |
| Novo NordiskOzempic, Rybelsus | $730 | $115,751106 claims |
| Johnson & JohnsonXarelto, Invokana | $49 | $92,697149 claims |
| Boehringer IngelheimJardiance, Spiriva Respimat, Combivent Respimat | $334 | $65,74993 claims |
| MerckJanuvia, Janumet Xr | $124 | $59,17395 claims |
| Astellas Pharma US IncMyrbetriq | $228 | $47,132114 claims |
| AstraZenecaFarxiga, Symbicort | $306 | $23,26349 claims |
| AbbVieLinzess | $122 | $10,50019 claims |
| Sumitomo Pharma America, Inc.Gemtesa | $34 | $6,68214 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 705 internal medicine providers in Kansas.
Other internal medicine in Hays
- Martin KankamLeavenworth$63.4M
- Mark HamblinKansas City$5.2M
- Katherine WillinghamTopeka$4.8M
- Raed Al RajabiWestwood$4.5M
- Leslie SpikesKansas City$4.5M
- Michael CoxTopeka$3.4M
- James RuhlmannHutchinson$2.8M
- Scott TeeterTopeka$1.2M
- Shadi HamdehKansas City$1.1M
- Kyle WorkKansas City$863K
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.