Shelby Real, PA
Physician Assistant · Carson City, NVNPI 1720557374
Payments from drug & device makers
Across 78 payments — averaging $20.93 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Abbott$337
- Nevro Corp.$321
- AbbVie$265
- Medtronic$178
- Amgen$153
- Scilex Pharmaceuticals Inc.$85
- plus $294 from 9 others
What the payments were for
- Food & beverage$1,633100%
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 |
|---|---|---|
| Abbott | 15 | $337 |
| Nevro Corp. | 7 | $321 |
| AbbVie | 16 | $265 |
| Medtronic | 9 | $178 |
| Amgen(2 entities) | 7 | $153 |
| Scilex Pharmaceuticals Inc. | 5 | $85 |
| Saluda Medical Americas, Inc. | 8 | $78 |
| Biohaven Pharmaceuticals, Inc. | 2 | $44 |
| Biohaven Pharmaceutical Holding Company Ltd. | 2 | $37 |
| Regeneron Healthcare Solutions, Inc. | 1 | $30 |
| GSK | 1 | $24 |
| Pfizer | 2 | $24 |
| Trevena, Inc. | 1 | $21 |
| Eisai Inc. | 1 | $20 |
| Kowa Pharmaceuticals America, Inc. | 1 | $16 |
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.
- Senza$139
How this compares
$1,633 in reported general payments places this provider in the 70th percentile of 881 physician assistant providers in Nevada.
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 | 1,932 | $49,479 |
| Oxycodone-AcetaminophenOxycodone Hcl/Acetaminophen | 663 | $19,815 |
| Oxycodone Hcl | 583 | $12,739 |
| OxycontinOxycodone Hcl | 24 | $10,847 |
| Gabapentin | 502 | $7,732 |
| Xtampza ErOxycodone Myristate | 18 | $7,366 |
| Morphine Sulfate ErMorphine Sulfate | 235 | $5,137 |
| Pregabalin | 268 | $3,496 |
| Cyclobenzaprine Hcl | 310 | $2,896 |
| Tramadol Hcl | 352 | $2,703 |
| Lidocaine | 46 | $2,543 |
| Buprenorphine-NaloxoneBuprenorphine Hcl/Naloxone Hcl | 33 | $2,529 |
| Celecoxib | 32 | $1,438 |
| Methadone Hcl | 85 | $1,279 |
| Methocarbamol | 81 | $964 |
Paid to pharmacies, not to this prescriber.
Other physician assistant in Carson City
- Kyle MachyniaStateline$119K
- Steven HawkesLas Vegas$70K
- John LarsenReno$49K
- Nathan MorganLas Vegas$44K
- Laura BiehleReno$36K
- Benjamin ProhaskaReno$31K
- Adam HarkiewiczHenderson$25K
- Stephanie DastrupLas Vegas$23K
- Sandra OviedoLas Vegas$21K
- Patrick JamesonLas Vegas$20K
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.