Thomas Spence, MD
Pulmonary Disease · Saint Louis, MONPI 1447221379
Payments from drug & device makers
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
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.
- Inspire$737
How this compares
$17,289 in reported general payments places this provider in the 80th percentile of 295 pulmonary disease 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 |
|---|---|---|
| Trelegy ElliptaFluticasone/Umeclidin/Vilanter | 638 | $505,191 |
| OfevNintedanib Esylate | 21 | $264,175 |
| Breo ElliptaFluticasone/Vilanterol | 142 | $76,243 |
| Anoro ElliptaUmeclidinium Brm/Vilanterol Tr | 142 | $66,342 |
| Breztri AerosphereBudesonide/Glycopyr/Formoterol | 59 | $40,039 |
| Spiriva RespimatTiotropium Bromide | 51 | $32,287 |
| EliquisApixaban | 19 | $27,276 |
| Incruse ElliptaUmeclidinium Bromide | 38 | $16,630 |
| SymbicortBudesonide/Formoterol Fumarate | 53 | $15,045 |
| Pirfenidone | 16 | $11,866 |
| Albuterol Sulfate HfaAlbuterol Sulfate | 412 | $11,011 |
| Stiolto RespimatTiotropium Br/Olodaterol Hcl | 14 | $7,901 |
| Fluticasone-SalmeterolFluticasone Propion/Salmeterol | 47 | $7,322 |
| Atrovent HfaIpratropium Bromide | 14 | $6,501 |
| Spiriva HandihalerTiotropium Bromide | 13 | $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.
| Company | Paid to this provider | Part 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
- Murali ChakinalaSaint Louis$2.4M
- Joseph OjileSaint Louis$2.1M
- Jeffrey HarrisSaint Louis$1.1M
- Kaharu SuminoSaint Louis$1.1M
- Tonya RussellSaint Louis$1M
- Alexander ChenSaint Louis$951K
- Daniel RosenbluthSaint Louis$903K
- Derek ByersSaint Louis$835K
- Jeffrey AtkinsonSaint Louis$604K
- James KringsSaint Louis$505K
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.