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Thomas Spence, MD

Pulmonary Disease · Saint Louis, MONPI 1447221379

Payments from drug & device makers

$17,289in general payments, 2019–2025

Across 910 payments — averaging $19.00 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.

  • GSK$3K
  • AstraZeneca$2K
  • Boehringer Ingelheim$2K
  • Actelion Pharmaceuticals US, Inc.$1K
  • Insmed, Inc.$1K
  • Inspire Medical Systems, Inc.$835
  • plus $6K from 44 others

What the payments were for

  • Consulting fees$180%
  • Travel & lodging$5923%
  • Food & beverage$16,67996%

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

$17,289 in reported general payments places this provider in the 80th percentile of 295 pulmonary disease providers in Missouri.

See all pulmonary disease providers in Missouri

Medicare billing

Part B allowed, 2024
$78,559
Medicare patients
392
Services billed
988

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
Trelegy ElliptaFluticasone/Umeclidin/Vilanter638$505,191
OfevNintedanib Esylate21$264,175
Breo ElliptaFluticasone/Vilanterol142$76,243
Anoro ElliptaUmeclidinium Brm/Vilanterol Tr142$66,342
Breztri AerosphereBudesonide/Glycopyr/Formoterol59$40,039
Spiriva RespimatTiotropium Bromide51$32,287
EliquisApixaban19$27,276
Incruse ElliptaUmeclidinium Bromide38$16,630
SymbicortBudesonide/Formoterol Fumarate53$15,045
Pirfenidone16$11,866
Albuterol Sulfate HfaAlbuterol Sulfate412$11,011
Stiolto RespimatTiotropium Br/Olodaterol Hcl14$7,901
Fluticasone-SalmeterolFluticasone Propion/Salmeterol47$7,322
Atrovent HfaIpratropium Bromide14$6,501
Spiriva HandihalerTiotropium Bromide13$6,349

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
GSKTrelegy Ellipta, Breo Ellipta, Anoro Ellipta, Incruse Ellipta, Arnuity Ellipta$3,171$670,323976 claims
Boehringer IngelheimOfev, Spiriva Respimat, Stiolto Respimat, Combivent Respimat$2,353$309,73397 claims
AstraZenecaBreztri Aerosphere, Symbicort$2,408$55,084112 claims
PfizerEliquis$146$27,27619 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 80th percentile of 295 pulmonary disease providers in Missouri.

Other pulmonary disease in Saint Louis

See the full list for Missouri

Where these figures come from

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