Vadim Koshkin, MD
Internal Medicine · Cleveland, OHNPI 1154684777
Payments from drug & device makers
What this record shows
The money is spread across several categories — consulting fees (54.1%), travel and lodging and speaking fees — rather than concentrated in one kind of arrangement. 24 manufacturers reported payments, led by Astellas Pharma Europe Ltd at 39.0% of the total. 2025 is the largest year on record at $59,716, 5.4 times the $10,980 reported in 2019. Among internal medicine clinicians in OH with any reported payments, this total sits in the top 5% — high for the specialty, which is a reason to read the composition above rather than the number alone.
Across 199 payments — averaging $797.28 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Astellas Pharma Europe Ltd$62K
- Pfizer$26K
- Seagen Inc.$19K
- AstraZeneca$11K
- Astellas Pharma Global Development$6K
- Ventana Medical Systems, Inc.$5K
- plus $30K from 18 others
Across 292 payments — averaging $20,357 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.
- Merck$2M
- Taiho Oncology, Inc.$1.7M
- Pfizer$576K
- Seagen Inc.$409K
- Lilly USA, LLC$341K
- Astellas US Technologies$281K
- plus $643K from 7 others
What the payments were for
- Consulting fees$85,80954%
- Speaking & faculty fees$17,79711%
- Travel & lodging$47,27130%
- Food & beverage$7,7405%
- Education$420%
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 |
|---|---|---|
| Astellas Pharma Europe Ltd | 37 | $61,818 |
| Pfizer | 34 | $26,427 |
| Seagen Inc. | 28 | $19,120 |
| AstraZeneca | 12 | $10,534 |
| Astellas Pharma Global Development | 6 | $5,598 |
| Ventana Medical Systems, Inc. | 5 | $5,296 |
| Janssen Scientific Affairs, LLC | 6 | $4,382 |
| Johnson & Johnson | 7 | $4,239 |
| Genentech USA, Inc. | 7 | $3,603 |
| Astellas Pharma US Inc | 7 | $3,560 |
| Merck | 7 | $3,006 |
| Eli Lilly | 6 | $2,263 |
| E.r. Squibb & Sons, L.L.C. | 4 | $2,159 |
| Dendreon Pharmaceuticals LLC | 4 | $1,582 |
| Clovis Oncology, Inc. | 2 | $1,294 |
| EMD Serono, Inc. | 5 | $1,172 |
| Janssen Research & Development, LLC | 6 | $781 |
| AVEO Pharmaceuticals, Inc. | 5 | $564 |
| Astellas Pharma Inc | 3 | $482 |
| Exelixis Inc. | 4 | $452 |
| Genentech, Inc. | 1 | $149 |
| Gilead | 1 | $104 |
| F. Hoffmann-la Roche AG | 1 | $61 |
| Immunitybio, Inc. | 1 | $15 |
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
$158,659 in reported general payments places this provider in the 95th percentile of 4,428 internal medicine providers in Ohio.
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 |
|---|---|---|
| Abiraterone Acetate | 31 | $8,002 |
| Prednisone | 22 | $295 |
| Dexamethasone | 13 | $271 |
| Ondansetron Hcl | 21 | $259 |
| Prochlorperazine Maleate | 11 | $99 |
| Alendronate Sodium | 11 | $28 |
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 |
|---|---|---|
| Janssen Scientific Affairs, LLCAbiraterone Acetate | $4,382 | $8,00231 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 95th percentile of 4,428 internal medicine providers in Ohio.
Other internal medicine in Cleveland
- Cyrus HarrisCleveland$726K
- Marina MagreyCleveland$312K
- Joshua LonginowCleveland$241K
- Emad MansoorCleveland$219K
- Syed BukhariCleveland$165K
- Suresh Kumar BalasubramanianCleveland$148K
- Christine Tanaka-EspositoCleveland$123K
- Carla HarwellCleveland$75K
- Amr MohamedCleveland$72K
- Adriano TonelliCleveland$71K
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.