Who Paid My Doc
Zachary Fletcher
Internal Medicine Festus, MO Doctor of Osteopathy
NPI 1184184525 CMS profile 8801984
1390 US Highway 61 Ste N-1000, Festus, MO 63028
General payments
$2,503
Research payments
$0
Ownership & investment interest
$0
Through program year 2025, Zachary Fletcher of Festus, MO is reported in the CMS Open Payments database as having received $2,503 across 130 general payments and $0 in research payments paid to them.
No combined total General, research and ownership are kept apart. Each is reported under its own rules, and ownership is not money that moved at all but the value of a stake held. A meal, a clinical trial grant and a shareholding do not add up to anything meaningful, so this site does not add them.
General payments for this record sit in the 82nd percentile of Internal Medicine profiles with reported payments. Percentile describes the distribution, not the conduct.
By program year
6 rows| Year | Kind | Relative to this record's peak year | Amount | Records |
|---|---|---|---|---|
| 2025 | General | $231 | 6 | |
| 2024 | General | $954 | 48 | |
| 2023 | General | $968 | 57 | |
| 2022 | General | $282 | 16 | |
| 2021 | General | $51 | 2 | |
| 2020 | General | $19 | 1 |
Beside peers
- Zachary Fletcher
- Internal Medicine median
- Middle half of Internal Medicine
- National median
In program year 2025, general payments to Zachary Fletcher were reported at $231. Among 52,115 Internal Medicine profiles paid that year, the median was $156 and the middle half received between $47 and $551.
Show as a table
| Year | Zachary Fletcher | Internal Medicine median | Middle half | National median |
|---|---|---|---|---|
| 2019 | $0 | $159 | $48–$570 | $163 |
| 2020 | $19 | $119 | $33–$402 | $114 |
| 2021 | $51 | $135 | $37–$521 | $132 |
| 2022 | $282 | $141 | $42–$496 | $149 |
| 2023 | $968 | $149 | $45–$519 | $160 |
| 2024 | $954 | $154 | $47–$537 | $164 |
| 2025 | $231 | $156 | $47–$551 | $169 |
Breakdown
A payment can name more than one product, so these amounts overlap and do not add up to the general-payment figure.
Prescribing to Medicare patients
Part D · data year 2024 · 98 drugsPart D claims
3,833
Drug cost
$321,071
Branded share of claims
21.5%
| Drug | Type | Relative to their largest | Claims | Drug cost |
|---|---|---|---|---|
| Eliquis Apixaban | Brand | 67 | $54,021 | |
| Ozempic Semaglutide | Brand | 36 | $48,090 | |
| Jardiance Empagliflozin | Brand | 41 | $46,467 | |
| Trulicity Dulaglutide | Brand | 19 | $33,727 | |
| Trelegy Ellipta Fluticasone/Umeclidin/Vilanter | Brand | 39 | $25,170 | |
| Mounjaro Tirzepatide | Brand | 22 | $23,068 | |
| Xarelto Rivaroxaban | Brand | 14 | $15,800 | |
| Myrbetriq Mirabegron | Brand | 18 | $11,421 | |
| Breztri Aerosphere Budesonide/Glycopyr/Formoterol | Brand | 12 | $10,453 | |
| Combivent Respimat Ipratropium/Albuterol Sulfate | Brand | 11 | $5,289 |
The 10 drugs with the highest cost, of 98 counted.
Drug cost is what was paid for the drugs at the pharmacy — by Medicare, the patient and others — and is not money to the prescriber. Medicare Part D only: drugs dispensed to Medicare beneficiaries. A drug with fewer than 11 claims for this prescriber is not published, so a missing drug does not mean zero. The medians are for the 104,182 Part D prescribers listed as Internal Medicine; they describe a distribution and say nothing about conduct.
Billing to Medicare
Part B · data year 2024 · 29 billing codesPaid by Medicare
$29,489
Medicare patients
205
Services billed
386
| Condition among their Medicare patients | Relative to the most common | Share of patients |
|---|---|---|
| High blood pressure | 75% | |
| Arthritis | 57% | |
| Chronic kidney disease | 56% | |
| Ischemic heart disease | 52% | |
| Heart failure | 50% | |
| Diabetes | 47% | |
| Depression | 40% | |
| COPD | 38% |
Medicare Part B only: services billed to Medicare. Rows covering fewer than 11 beneficiaries are not published. Only drugs given in the clinic are itemised here; the rest of what this provider billed is in the total above.
Payments and prescribing
First 5 of 34 products · payments 2024Two separate records. The payments come from Open Payments and the claims from Medicare. They are set side by side because they name the same product; they do not show that a payment affected a prescription.
| Product | Paid by | Related payments | Part D claims | Part B services |
|---|---|---|---|---|
| MOUNJARO |
|
$107 | 22 | — |
| FARXIGA |
|
$79 | — | — |
| QULIPTA |
|
$67 | — | — |
| ELIQUIS |
|
$56 | 67 | — |
| BREZTRI |
|
$34 | 12 | — |
A dash means Medicare published no figure for this doctor and product — fewer than 11 claims, or the product is not covered under that part — which is not the same as none. Payments are general payments only; one that names several products is split evenly between them, so an amount is payments related to the product, not money paid for it.
See more in the dashboard: 25 with a free account, all 34 with PatronRecords
130 reportedEvery payment, record by record
Date, company, amount, what it was for and the product named — filter by year, kind and company, or download as CSV.
Other Internal Medicine in Missouri
Related records
Internal Medicine in Missouri
Practitioners in the same specialty and state, ranked by reported value.
All Internal Medicine
Everyone recorded under this specialty, nationwide.
Doctors in Missouri
Every practitioner in the state with a reported payment.
How to read this page
What each amount means, and what it does not mean.
What this means
U.S. law requires drug and medical device manufacturers to report payments and transfers of value they make to physicians and teaching hospitals. The Centers for Medicare & Medicaid Services publishes that record each year. This page shows what was reported about this person, and nothing else.
An ownership interest is different from the other two. It is not a payment: it is a stake — shares, options, a partnership holding — that a physician or an immediate family member held in a manufacturer during that year. The figure shown is what the stake was reported to be worth.
Research payments frequently pass through a clinician to the institution running a trial, and rarely represent personal income. They should be read differently from general payments.