Payment overview · 2025
General Payments
$83.86
3 reported records · 2 companies
Healthcare provider profile · identity verified
Karl M Holmes, PAC
Physician Assistants & Advanced Practice Nursing Providers|Physician Assistant · KEYSTONE, IA · NPI 1124006887
Verified facts
What the public records show
CMS Open Payments records show Karl M Holmes, PAC received $83.86 in general payments during 2025 across 3 reported records.
Lilly USA, LLC accounted for 53.7% of that reported general-payment amount.
The Open Payments records used for this analysis explicitly named 1 associated product.
A separate comparison found the same explicitly named product in public Medicare Part D data: Ozempic.
Lilly USA, LLC reported payments to this doctor in 2025. Across the 2025 Open Payments General Payment records loaded for this analysis, that same reporting entity reported JARDIANCE as an associated drug or biological on 47708 records involving 23833 distinct recipient NPIs. Public Medicare Part D data also shows 22 claims for Jardiance by this doctor in 2024.
Lilly USA, LLC reported payments to this doctor in 2025. Across the 2025 Open Payments General Payment records loaded for this analysis, that same reporting entity reported TRULICITY as an associated drug or biological on 71 records involving 57 distinct recipient NPIs. Public Medicare Part D data also shows 17 claims for Trulicity by this doctor in 2024.
Novo Nordisk Inc reported payments to this doctor in 2025. Across the 2025 Open Payments General Payment records loaded for this analysis, that same reporting entity reported Ozempic as an associated drug or biological on 261625 records involving 77793 distinct recipient NPIs. Public Medicare Part D data also shows 77 claims for Ozempic by this doctor in 2024.
These records do not establish that a payment influenced prescribing or medical care.
Separate record types
Research & Ownership
Research Payments (direct recipient): not present in the loaded data
Associated Research Funding (for example, named PI): not present in the loaded data
Ownership / Investment: not present in the loaded data
These categories are never added into the General Payments headline. Associated research funding must not be described as money the doctor personally received unless the source record supports that conclusion.
Who paid this doctor?
Companies in 2025 General Payments
| Reported company | Canonical company | Amount | Share | Records | Year |
|---|---|---|---|---|---|
| Lilly USA, LLC | Unresolved — no canonical attribution shown | $45.00 | 53.7% | 1 | 2025 |
| Novo Nordisk Inc | Unresolved — no canonical attribution shown | $38.86 | 46.3% | 2 | 2025 |
What were the payments for?
Payment categories
| Category | Amount | Records |
|---|---|---|
| Education | $45.00 | 1 |
| Food and Beverage | $38.86 | 2 |
A meal, consulting fee, royalty, and travel payment describe different kinds of reported relationships and should not be interpreted as equivalent.
Analysis 1 · Payment-linked products
Products named in Open Payments records
| Reported product | Type | Reported company | Related amount* | Records | Year |
|---|---|---|---|---|---|
| Ozempic Normalized: ozempic |
Drug | Novo Nordisk Inc | $38.86 | 2 | 2025 |
Source payment records
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* Product-associated amounts are non-additive because one payment record may name more than one product.
These products were named on specific Open Payments records. A named product does not show that the payment influenced treatment or prescribing.
Public prescribing for products named in payments
| Open Payments product | Payment year | Part D brand | Part D year | Claims | Match method | Source |
|---|---|---|---|---|---|---|
| Ozempic ozempic |
2025 | Ozempic | 2024 | 77 | exact normalized | Medicare Part D |
The presence of the same drug in both datasets does not show that a payment caused or influenced a prescription.
Analysis 2 · Same-company prescribing overlap
Drugs reported in other payments from the same company that also appear in Medicare Part D
This analysis is independent from products named on this doctor’s individual payment records. A row appears only when the exact Open Payments reporting entity paid this doctor, that same reporting entity reported the drug or biological on at least 10 loaded General Payment records involving at least 2 distinct recipient NPIs, and this doctor has the same non-generic brand in public Part D data. This does not mean the company owns or manufactures the drug.
| Paying company | Payment year | Drug reported by same entity | Open Payments evidence | Part D | Claims | Beneficiaries |
|---|---|---|---|---|---|---|
| Lilly USA, LLC Exact reporting entity; no affiliate inference |
2025 | JARDIANCE open payments reported associated product |
CMS Open Payments — General Payments 47708 supporting records · 23833 recipient NPIs · example record 1186464557 |
Jardiance · 2024 Exact normalized brand match · 1 Part D row |
22 | suppressed by CMS |
| Lilly USA, LLC Exact reporting entity; no affiliate inference |
2025 | TRULICITY open payments reported associated product |
CMS Open Payments — General Payments 71 supporting records · 57 recipient NPIs · example record 1186464601 |
Trulicity · 2024 Exact normalized brand match · 1 Part D row |
17 | suppressed by CMS |
| Novo Nordisk Inc Exact reporting entity; no affiliate inference |
2025 | Ozempic open payments reported associated product |
CMS Open Payments — General Payments 261625 supporting records · 77793 recipient NPIs · example record 1188130076 |
Ozempic · 2024 Exact normalized brand match · 1 Part D row |
77 | 13 |
These facts do not show that a payment was for the drug, that the company owns or manufactures the drug, or that a payment caused or influenced prescribing.
Public Medicare Part D data
Provider-and-drug rows loaded for 2024
| Brand | Generic | Claims | Beneficiaries |
|---|---|---|---|
| Levothyroxine Sodium | Levothyroxine Sodium | 288 | 73 |
| Amlodipine Besylate | Amlodipine Besylate | 238 | 72 |
| Atorvastatin Calcium | Atorvastatin Calcium | 238 | 71 |
| Lisinopril | Lisinopril | 235 | 66 |
| Rosuvastatin Calcium | Rosuvastatin Calcium | 227 | 66 |
| Pantoprazole Sodium | Pantoprazole Sodium | 182 | 50 |
| Metoprolol Succinate | Metoprolol Succinate | 179 | 51 |
| Hydrochlorothiazide | Hydrochlorothiazide | 145 | 38 |
| Omeprazole | Omeprazole | 145 | 45 |
| Potassium Chloride | Potassium Chloride | 143 | 36 |
| Furosemide | Furosemide | 139 | 47 |
| Prednisone | Prednisone | 129 | 73 |
| Tramadol Hcl | Tramadol Hcl | 127 | 31 |
| Meloxicam | Meloxicam | 124 | 36 |
| Losartan Potassium | Losartan Potassium | 123 | 32 |
| Hydrocodone-Acetaminophen | Hydrocodone/Acetaminophen | 120 | 12 |
| Metformin Hcl Er | Metformin Hcl | 117 | 35 |
| Simvastatin | Simvastatin | 102 | 24 |
| Ezetimibe | Ezetimibe | 97 | 22 |
| Albuterol Sulfate Hfa | Albuterol Sulfate | 96 | 51 |
| Bupropion Xl | Bupropion Hcl | 94 | 19 |
| Ibandronate Sodium | Ibandronate Sodium | 93 | 29 |
| Gabapentin | Gabapentin | 92 | 27 |
| Metformin Hcl | Metformin Hcl | 90 | 26 |
| Atenolol | Atenolol | 86 | 22 |
| Trazodone Hcl | Trazodone Hcl | 79 | 17 |
| Ozempic | Semaglutide | 77 | 13 |
| Zolpidem Tartrate | Zolpidem Tartrate | 72 | 14 |
| Tresiba Flextouch U-200 | Insulin Degludec | 67 | 12 |
| Azithromycin | Azithromycin | 66 | 59 |
| Duloxetine Hcl | Duloxetine Hcl | 65 | 15 |
| Lorazepam | Lorazepam | 64 | 12 |
| Sertraline Hcl | Sertraline Hcl | 64 | 19 |
| Methylprednisolone | Methylprednisolone | 63 | 57 |
| Fluticasone Propionate | Fluticasone Propionate | 60 | 27 |
| Cyclobenzaprine Hcl | Cyclobenzaprine Hcl | 58 | 20 |
| Farxiga | Dapagliflozin Propanediol | 57 | 16 |
| Xarelto | Rivaroxaban | 55 | suppressed |
| Eliquis | Apixaban | 54 | 13 |
| Ropinirole Hcl | Ropinirole Hcl | 54 | 17 |
| Venlafaxine Hcl Er | Venlafaxine Hcl | 53 | suppressed |
| Montelukast Sodium | Montelukast Sodium | 52 | 16 |
| Lovastatin | Lovastatin | 51 | 16 |
| Pravastatin Sodium | Pravastatin Sodium | 51 | 18 |
| Allopurinol | Allopurinol | 50 | 18 |
| Cefadroxil | Cefadroxil | 49 | 35 |
| Alprazolam | Alprazolam | 48 | suppressed |
| Famotidine | Famotidine | 48 | 14 |
| Escitalopram Oxalate | Escitalopram Oxalate | 46 | 12 |
| Metoprolol Tartrate | Metoprolol Tartrate | 46 | 16 |
| Buspirone Hcl | Buspirone Hcl | 45 | 13 |
| Clonazepam | Clonazepam | 45 | suppressed |
| Tamsulosin Hcl | Tamsulosin Hcl | 45 | 15 |
| Amoxicillin-Clavulanate Potass | Amoxicillin/Potassium Clav | 43 | 41 |
| Paroxetine Hcl | Paroxetine Hcl | 43 | suppressed |
| Ramipril | Ramipril | 42 | suppressed |
| Nitrofurantoin Mono-Macro | Nitrofurantoin Monohyd/M-Cryst | 41 | 32 |
| Pregabalin | Pregabalin | 41 | 13 |
| Repatha Sureclick | Evolocumab | 39 | suppressed |
| Loperamide | Loperamide Hcl | 36 | suppressed |
| Synthroid | Levothyroxine Sodium | 36 | suppressed |
| Amoxicillin | Amoxicillin | 34 | 26 |
| Doxycycline Monohydrate | Doxycycline Monohydrate | 34 | 29 |
| Sumatriptan Succinate | Sumatriptan Succinate | 34 | suppressed |
| Cefdinir | Cefdinir | 31 | 25 |
| Clopidogrel | Clopidogrel Bisulfate | 31 | suppressed |
| Alendronate Sodium | Alendronate Sodium | 30 | suppressed |
| Verapamil Er | Verapamil Hcl | 30 | suppressed |
| Fenofibrate | Fenofibrate | 29 | suppressed |
| Fenofibrate | Fenofibrate Nanocrystallized | 28 | suppressed |
| Mirtazapine | Mirtazapine | 28 | suppressed |
| Tresiba Flextouch U-100 | Insulin Degludec | 28 | suppressed |
| Carvedilol | Carvedilol | 27 | suppressed |
| Colesevelam Hcl | Colesevelam Hcl | 27 | suppressed |
| Nystatin | Nystatin | 27 | suppressed |
| Bisoprolol-Hydrochlorothiazide | Bisoprolol/Hydrochlorothiazide | 26 | suppressed |
| Fluconazole | Fluconazole | 26 | 14 |
| Lisinopril-Hydrochlorothiazide | Lisinopril/Hydrochlorothiazide | 23 | suppressed |
| Tizanidine Hcl | Tizanidine Hcl | 23 | 11 |
| Ventolin Hfa | Albuterol Sulfate | 23 | 11 |
| Cholestyramine | Cholestyramine (With Sugar) | 22 | suppressed |
| Jardiance | Empagliflozin | 22 | suppressed |
| Citalopram Hbr | Citalopram Hydrobromide | 21 | suppressed |
| Finasteride | Finasteride | 21 | suppressed |
| Fluoxetine Hcl | Fluoxetine Hcl | 21 | suppressed |
| Glipizide Er | Glipizide | 21 | suppressed |
| Clorazepate Dipotassium | Clorazepate Dipotassium | 20 | suppressed |
| Solifenacin Succinate | Solifenacin Succinate | 20 | suppressed |
| Lantus Solostar | Insulin Glargine,hum.Rec.Anlog | 19 | suppressed |
| Levofloxacin | Levofloxacin | 19 | 16 |
| Nitroglycerin | Nitroglycerin | 19 | 13 |
| Topiramate | Topiramate | 19 | suppressed |
| Breztri Aerosphere | Budesonide/Glycopyr/Formoterol | 18 | suppressed |
| Esomeprazole Magnesium | Esomeprazole Magnesium | 18 | suppressed |
| Fentanyl | Fentanyl | 18 | suppressed |
| Nifedipine Er | Nifedipine | 18 | suppressed |
| Spironolactone | Spironolactone | 18 | suppressed |
| Triamterene-Hydrochlorothiazid | Triamterene/Hydrochlorothiazid | 18 | suppressed |
| Amitriptyline Hcl | Amitriptyline Hcl | 17 | suppressed |
| Budesonide-Formoterol Fumarate | Budesonide/Formoterol Fumarate | 17 | suppressed |
| Trulicity | Dulaglutide | 17 | suppressed |
| Donepezil Hcl | Donepezil Hcl | 16 | suppressed |
| Losartan-Hydrochlorothiazide | Losartan/Hydrochlorothiazide | 16 | suppressed |
| Benazepril Hcl | Benazepril Hcl | 15 | suppressed |
| Clotrimazole-Betamethasone | Clotrimazole/Betamethasone Dip | 15 | suppressed |
| Testosterone Cypionate | Testosterone Cypionate | 15 | suppressed |
| Cephalexin | Cephalexin | 14 | suppressed |
| Hydroxyzine Hcl | Hydroxyzine Hcl | 14 | 11 |
| Mupirocin | Mupirocin | 14 | 12 |
| Oxybutynin Chloride Er | Oxybutynin Chloride | 14 | suppressed |
| Propranolol Hcl Er | Propranolol Hcl | 14 | suppressed |
| Breo Ellipta | Fluticasone/Vilanterol | 13 | suppressed |
| Butalbital-Acetaminophen-Caffe | Butalb/Acetaminophen/Caffeine | 13 | suppressed |
| Ciprofloxacin Hcl | Ciprofloxacin Hcl | 13 | suppressed |
| Hydrocortisone | Hydrocortisone | 13 | 11 |
| Lithium Carbonate | Lithium Carbonate | 13 | suppressed |
| Oxybutynin Chloride | Oxybutynin Chloride | 13 | suppressed |
| Triamcinolone Acetonide | Triamcinolone Acetonide | 13 | suppressed |
| Ultra-Fine Nano Pen Needle | Pen Needle, Diabetic | 13 | suppressed |
| Warfarin Sodium | Warfarin Sodium | 13 | suppressed |
| Azelastine Hcl | Azelastine Hcl | 12 | suppressed |
| Celecoxib | Celecoxib | 12 | suppressed |
| Fluticasone-Salmeterol | Fluticasone Propion/Salmeterol | 12 | suppressed |
| Gemfibrozil | Gemfibrozil | 12 | suppressed |
| Levocetirizine Dihydrochloride | Levocetirizine Dihydrochloride | 12 | suppressed |
| Torsemide | Torsemide | 12 | suppressed |
| Meclizine Hcl | Meclizine Hcl | 11 | suppressed |
| Qvar Redihaler | Beclomethasone Dipropionate | 11 | suppressed |
| Trelegy Ellipta | Fluticasone/Umeclidin/Vilanter | 11 | suppressed |
Timeline
Payment and prescribing data by year
Open Payments and Medicare Part D may refer to different years. They are shown separately rather than aligned as if they describe the same period.
| Year | General Payments | Main payer | Explicit products | Company overlaps | Part D coverage |
|---|---|---|---|---|---|
| 2025 | $83.86 · 3 records | Lilly USA, LLC | Ozempic | 3 | — |
| 2024 | — | — | — | — | Complete |
Questions to ask
Questions you could discuss with your doctor
- What role, if any, does Ozempic play in your treatment recommendations for me?
- How do you evaluate evidence when you have a financial relationship with Lilly USA, LLC?
- Are there reasonable alternatives I should understand when we discuss treatment options?
- How should I interpret the industry-payment records shown here in the context of my care?
These are general questions generated from reviewed templates. They are not personalized medical advice.
Sources and limitations
How to read this page
- Payment and Medicare prescribing data can cover different years; every comparison shows both years explicitly.
- Part D does not represent a doctor’s entire practice; it excludes many patients and is subject to CMS public-release thresholds.
- Company–drug relationships must have an auditable source, a precise relationship type, and a valid evidence period. Unresolved mappings are not published.
- Generic drug claims are not attributed to a specific manufacturer without manufacturer-level evidence.
- When a source extract is incomplete, missing rows are never treated as proof of no payments or no prescriptions.
Loaded source releases
| Dataset | Year | Publication | Source |
|---|---|---|---|
| CMS Open Payments — General Payments | 2025 | 2026-06-30 | Original source |
| Medicare Part D Prescribers by Provider and Drug | 2024 | 2026-05-06 | Original source |
| NPPES Data Dissemination V2 | current / reference data | 2026-08-10 | Original source |
Full methodology · Questions & answers · Report a possible error