Terry Fletcher, MD
Pain Medicine · Little Rock, ARNPI 1851443832
Payments from drug & device makers
What this record shows
The money is spread across several categories — food and beverage (58.9%), consulting fees and travel and lodging — rather than concentrated in one kind of arrangement. 20 manufacturers reported payments, led by Southern Spine, LLC at 24.8% of the total. Reporting peaked in 2023 at $1,488 and has fallen 92.1% since, to $117 in 2025. That places this record below the midpoint for pain medicine clinicians in AR, where the typical reported total is $3,271.
Across 71 payments — averaging $45.46 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Southern Spine, LLC$800
- Relievant Medsystems, Inc.$784
- Boston Scientific$421
- Medtronic$326
- Abbott$209
- Vertiflex, Inc.$122
- plus $567 from 14 others
What the payments were for
- Consulting fees$80025%
- Travel & lodging$52816%
- Food & beverage$1,90059%
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 |
|---|---|---|
| Southern Spine, LLC | 1 | $800 |
| Relievant Medsystems, Inc. | 3 | $784 |
| Boston Scientific | 18 | $421 |
| Medtronic(2 entities) | 11 | $326 |
| Abbott | 6 | $209 |
| Vertiflex, Inc. | 1 | $122 |
| Stimwave Technologies Incorporated | 4 | $116 |
| Collegium Pharmaceutical, Inc. | 5 | $95 |
| AbbVie(2 entities) | 5 | $82 |
| Biodelivery Sciences International, Inc. | 3 | $58 |
| Tersera Therapeutics LLC | 2 | $40 |
| Lilly USA, LLC | 3 | $38 |
| Nevro Corp. | 2 | $32 |
| Vertex | 1 | $22 |
| Nalu Medical, Inc. | 1 | $17 |
| Kaleo, Inc. | 1 | $14 |
| Pfizer | 1 | $14 |
| Daiichi Sankyo Inc. | 1 | $14 |
| Bioventus LLC | 1 | $12 |
| Piramal Critical Care | 1 | $12 |
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.
- Intracept$1,813
- PROCLAIM$127
- Infinion 16$123
- Superion ISS$122
How this compares
$3,228 in reported general payments places this provider in the 45th percentile of 53 pain medicine providers in Arkansas.
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 | 1,597 | $46,625 |
| Oxycodone-AcetaminophenOxycodone Hcl/Acetaminophen | 764 | $29,542 |
| Xtampza ErOxycodone Myristate | 35 | $14,250 |
| Oxycodone Hcl | 642 | $10,387 |
| Hysingla ErHydrocodone Bitartrate | 14 | $7,318 |
| Fentanyl | 61 | $7,248 |
| Pregabalin | 231 | $7,072 |
| Morphine Sulfate ErMorphine Sulfate | 171 | $6,775 |
| Gabapentin | 411 | $6,161 |
| Naloxone Hcl | 95 | $6,138 |
| Tizanidine Hcl | 256 | $3,264 |
| Morphine Sulfate | 127 | $2,542 |
| Hydromorphone Hcl | 47 | $2,127 |
| Tramadol Hcl | 238 | $2,047 |
| Cyclobenzaprine Hcl | 143 | $1,943 |
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 |
|---|---|---|
| Collegium Pharmaceutical, Inc.Xtampza Er | $95 | $14,25035 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 45th percentile of 53 pain medicine providers in Arkansas.
Other pain medicine in Little Rock
- Stephen PaulusLittle Rock$75K
- Julio OlayaLittle Rock$22K
- Christopher MocekLittle Rock$10K
- Ann IkonneLittle Rock$8K
- Saint AdeogbaLittle Rock$6K
- Andrew CainLittle Rock$5K
- Krishnappa PrasadLittle Rock$5K
- Thomas HartLittle Rock$4K
- James CaldwellLittle Rock$4K
- Drew BeasleyLittle Rock$3K
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.