Steven Couch, MD
Ophthalmology · Saint Louis, MONPI 1578590634
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 93.8% of the total across 21 separate payments, which is the pattern of a clinician who attends manufacturer presentations rather than one with a consulting arrangement. Amgen accounts for 95.2% of it on its own, with 1 other manufacturer making up the rest. Reporting peaked in 2022 at $525 and has fallen 90.4% since, to $50 in 2025. That places this record below the midpoint for ophthalmology clinicians in MO, where the typical reported total is $1,365.
Across 21 payments — averaging $50.05 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Amgen$1K
- ANI Pharmaceuticals, Inc.$50
Across 10 payments — averaging $116,744 each. Payments tied to a research study. These frequently flow through the physician to a hospital or research institution rather than to the physician personally.
- Amgen$1.2M
What the payments were for
- Consulting fees$656%
- Food & beverage$98694%
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 |
|---|---|---|
| Amgen | 20 | $1,000 |
| ANI Pharmaceuticals, Inc. | 1 | $50 |
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.
- TEPEZZA$567
How this compares
$1,051 in reported general payments places this provider in the 40th percentile of 286 ophthalmology providers in Missouri.
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 |
|---|---|---|
| ErythromycinErythromycin Base | 393 | $3,602 |
| Neomycin-Polymyxin-DexamethNeomycin/Polymyxin B/Dexametha | 30 | $248 |
| Ondansetron OdtOndansetron | 18 | $149 |
| Amoxicillin-Clavulanate PotassAmoxicillin/Potassium Clav | 11 | $95 |
| Prednisone | 19 | $71 |
Paid to pharmacies, not to this prescriber.
Other ophthalmology in Saint Louis
- Ranjan MalhotraSaint Louis$809K
- Gregg BerdySaint Louis$360K
- Rajendra ApteSaint Louis$112K
- Ian PithaSaint Louis$85K
- Senthil KrishnasamySaint Louis$46K
- Navin TekwaniSaint Louis$34K
- Steven LeeSaint Louis$33K
- John GalanisSaint Louis$20K
- Bruce CohenSaint Louis$11K
- Waseem AnsariSaint Louis$9K
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.