Payment overview · 2025
General Payments
$1,291.37
63 reported records · 17 companies
Healthcare provider profile · identity verified
Josh Littell
Physician Assistants & Advanced Practice Nursing Providers|Nurse Practitioner|Acute Care · CLEVELAND, TN · NPI 1386322147
Verified facts
What the public records show
CMS Open Payments records show Josh Littell received $1,291.37 in general payments during 2025 across 63 reported records.
Fresenius USA Marketing, Inc. accounted for 13.5% of that reported general-payment amount.
The Open Payments records used for this analysis explicitly named 18 associated products.
A separate comparison found the same explicitly named product in public Medicare Part D data: Farxiga.
AstraZeneca Pharmaceuticals LP reported payments to this doctor in 2025. Across the 2025 Open Payments General Payment records loaded for this analysis, that same reporting entity reported FARXIGA as an associated drug or biological on 106133 records involving 42906 distinct recipient NPIs. Public Medicare Part D data also shows 13 claims for Farxiga 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 |
|---|---|---|---|---|---|
| Fresenius USA Marketing, Inc. | Unresolved — no canonical attribution shown | $174.36 | 13.5% | 9 | 2025 |
| Travere Therapeutics, Inc. | Unresolved — no canonical attribution shown | $151.12 | 11.7% | 6 | 2025 |
| AstraZeneca Pharmaceuticals LP | Unresolved — no canonical attribution shown | $144.75 | 11.2% | 7 | 2025 |
| Otsuka America Pharmaceutical, Inc. | Unresolved — no canonical attribution shown | $140.57 | 10.9% | 6 | 2025 |
| Vifor Pharma, Inc. | Unresolved — no canonical attribution shown | $121.50 | 9.4% | 5 | 2025 |
| Bayer Healthcare Pharmaceuticals Inc. | Unresolved — no canonical attribution shown | $109.16 | 8.4% | 6 | 2025 |
| Amgen Inc. | Unresolved — no canonical attribution shown | $77.44 | 6.0% | 5 | 2025 |
| Ardelyx, Inc. | Unresolved — no canonical attribution shown | $63.46 | 4.9% | 3 | 2025 |
| SCPHARMACEUTICALS INC. | Unresolved — no canonical attribution shown | $61.46 | 4.8% | 4 | 2025 |
| ANI Pharmaceuticals, Inc. | Unresolved — no canonical attribution shown | $51.28 | 4.0% | 2 | 2025 |
| Boehringer Ingelheim Pharmaceuticals, Inc. | Unresolved — no canonical attribution shown | $49.98 | 3.9% | 3 | 2025 |
| Novartis Pharmaceuticals Corporation | Unresolved — no canonical attribution shown | $32.04 | 2.5% | 1 | 2025 |
| OPKO Pharmaceuticals, LLC | Unresolved — no canonical attribution shown | $30.00 | 2.3% | 2 | 2025 |
| Mallinckrodt Hospital Products Inc. | Unresolved — no canonical attribution shown | $29.75 | 2.3% | 1 | 2025 |
| CorMedix Inc. | Unresolved — no canonical attribution shown | $19.52 | 1.5% | 1 | 2025 |
| Alexion Pharmaceuticals, Inc. | Unresolved — no canonical attribution shown | $19.05 | 1.5% | 1 | 2025 |
| Lilly USA, LLC | Unresolved — no canonical attribution shown | $15.93 | 1.2% | 1 | 2025 |
What were the payments for?
Payment categories
| Category | Amount | Records |
|---|---|---|
| Food and Beverage | $1,274.87 | 62 |
| Education | $16.50 | 1 |
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 |
|---|---|---|---|---|---|
| VELPHORO Normalized: velphoro |
Drug | Fresenius USA Marketing, Inc. | $174.36 | 9 | 2025 |
Source payment records
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| FARXIGA Normalized: farxiga |
Drug | AstraZeneca Pharmaceuticals LP | $144.75 | 7 | 2025 |
Source payment records
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| Veltassa Normalized: veltassa |
Drug | Vifor Pharma, Inc. | $121.50 | 5 | 2025 |
Source payment records
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| JYNARQUE Normalized: jynarque |
Drug | Otsuka America Pharmaceutical, Inc. | $115.65 | 5 | 2025 |
Source payment records
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| Kerendia Normalized: kerendia |
Drug | Bayer Healthcare Pharmaceuticals Inc. | $109.16 | 6 | 2025 |
Source payment records
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| TAVNEOS Normalized: tavneos |
Drug | Amgen Inc. | $77.44 | 5 | 2025 |
Source payment records
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| IBSRELA Normalized: ibsrela |
Drug | Ardelyx, Inc. | $63.46 | 3 | 2025 |
Source payment records
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| FUROSCIX Normalized: furoscix |
Drug | SCPHARMACEUTICALS INC. | $61.46 | 4 | 2025 |
Source payment records
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| PURIFIED CORTROPHIN GEL Normalized: purified cortrophin gel |
Drug | ANI Pharmaceuticals, Inc. | $51.28 | 2 | 2025 |
Source payment records
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| JARDIANCE Normalized: jardiance |
Drug | Boehringer Ingelheim Pharmaceuticals, Inc. | $49.98 | 3 | 2025 |
Source payment records
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| Fabhalta Normalized: fabhalta |
Drug | Novartis Pharmaceuticals Corporation | $32.04 | 1 | 2025 |
Source payment records
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| Vanrafia Normalized: vanrafia |
Drug | Novartis Pharmaceuticals Corporation | $32.04 | 1 | 2025 |
Source payment records
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| RAYALDEE Normalized: rayaldee |
Drug | OPKO Pharmaceuticals, LLC | $30.00 | 2 | 2025 |
Source payment records
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| ACTHAR Normalized: acthar |
Biological | Mallinckrodt Hospital Products Inc. | $29.75 | 1 | 2025 |
Source payment records
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| VOYXACT Normalized: voyxact |
Drug | Otsuka America Pharmaceutical, Inc. | $24.92 | 1 | 2025 |
Source payment records
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| DEFENCATH Normalized: defencath |
Drug | CorMedix Inc. | $19.52 | 1 | 2025 |
Source payment records
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| ULTOMIRIS Normalized: ultomiris |
Biological | Alexion Pharmaceuticals, Inc. | $19.05 | 1 | 2025 |
Source payment records
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| ZEPBOUND Normalized: zepbound |
Drug | Lilly USA, LLC | $15.93 | 1 | 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 |
|---|---|---|---|---|---|---|
| FARXIGA farxiga |
2025 | Farxiga | 2024 | 13 Beneficiary count suppressed |
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 |
|---|---|---|---|---|---|---|
| AstraZeneca Pharmaceuticals LP Exact reporting entity; no affiliate inference |
2025 | FARXIGA open payments reported associated product |
CMS Open Payments — General Payments 106133 supporting records · 42906 recipient NPIs · example record 1206131362 |
Farxiga · 2024 Exact normalized brand match · 1 Part D row |
13 | suppressed by CMS |
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 |
|---|---|---|---|
| Furosemide | Furosemide | 54 | 24 |
| Amlodipine Besylate | Amlodipine Besylate | 52 | 26 |
| Famotidine | Famotidine | 50 | 26 |
| Lisinopril | Lisinopril | 43 | 21 |
| Potassium Chloride | Potassium Chloride | 27 | suppressed |
| Chlorthalidone | Chlorthalidone | 21 | 12 |
| Losartan Potassium | Losartan Potassium | 21 | suppressed |
| Hydralazine Hcl | Hydralazine Hcl | 18 | suppressed |
| Allopurinol | Allopurinol | 17 | suppressed |
| Torsemide | Torsemide | 15 | suppressed |
| Nifedipine Er | Nifedipine | 14 | suppressed |
| Farxiga | Dapagliflozin Propanediol | 13 | suppressed |
| Metoprolol Tartrate | Metoprolol Tartrate | 12 | suppressed |
| Spironolactone | Spironolactone | 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 | $1,291.37 · 63 records | Fresenius USA Marketing, Inc. | ACTHAR, DEFENCATH, FARXIGA, FUROSCIX, Fabhalta, IBSRELA, JARDIANCE, JYNARQUE, Kerendia, PURIFIED CORTROPHIN GEL, RAYALDEE, TAVNEOS, ULTOMIRIS, VELPHORO, VOYXACT, Vanrafia, Veltassa, ZEPBOUND | 1 | — |
| 2024 | — | — | — | — | Complete |
Questions to ask
Questions you could discuss with your doctor
- What role, if any, does Farxiga play in your treatment recommendations for me?
- How do you evaluate evidence when you have a financial relationship with AstraZeneca Pharmaceuticals LP?
- 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