RxDoctor Payments Data

Shreela Mishra, MD

Endocrinology, Diabetes & Metabolism · Fresno, CANPI 1013276104

Payments from drug & device makers

$7,181in general payments, 2019–2025

Across 304 payments — averaging $23.62 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.

  • Novo Nordisk$627
  • Dexcom, Inc.$623
  • Lilly USA, LLC$619
  • Bayer$454
  • Abbott$417
  • Amgen$371
  • plus $4K from 36 others

What the payments were for

  • Food & beverage$7,05098%
  • Education$120%
  • Gifts$1192%

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

19
20
21
22
23
24
25

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.

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

$7,181 in reported general payments places this provider in the 70th percentile of 952 endocrinology, diabetes & metabolism providers in California.

See all endocrinology, diabetes & metabolism providers in California

Medicare billing

Part B allowed, 2024
$63,336
Medicare patients
339
Services billed
557

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

DrugClaimsCost to plans & patients
OzempicSemaglutide251$276,690
TrulicityDulaglutide71$90,719
JardianceEmpagliflozin84$89,020
FarxigaDapagliflozin Propanediol78$82,609
Somatuline DepotLanreotide Acetate13$80,252
MounjaroTirzepatide42$47,335
RybelsusSemaglutide31$42,348
Toujeo Max SolostarInsulin Glargine,hum.Rec.Anlog18$30,996
Tresiba Flextouch U-100Insulin Degludec52$26,194
Toujeo SolostarInsulin Glargine,hum.Rec.Anlog31$19,657
Humalog Kwikpen U-100Insulin Lispro71$18,258
HumatropeSomatropin11$18,069
Tresiba Flextouch U-200Insulin Degludec22$17,720
Basaglar Kwikpen U-100Insulin Glargine,hum.Rec.Anlog56$17,188
SynthroidLevothyroxine Sodium136$14,596

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.

CompanyPaid to this providerPart D cost of their drugs
Novo NordiskOzempic, Rybelsus, Novolog$627$328,334298 claims
Lilly USA, LLCTrulicity, Mounjaro, Humatrope$619$156,123124 claims
Boehringer IngelheimJardiance$306$89,02084 claims
AstraZenecaFarxiga$329$82,60978 claims
Ipsen Biopharmaceuticals, IncSomatuline Depot$67$80,25213 claims
AbbVieSynthroid$23$14,596136 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 70th percentile of 952 endocrinology, diabetes & metabolism providers in California.

Other endocrinology, diabetes & metabolism in Fresno

See the full list for California

Where these figures come from

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