Payment overview · 2025
General Payments
$209.86
8 reported records · 5 companies
Healthcare provider profile · identity verified
Michelle Libretti, ARNP
Physician Assistants & Advanced Practice Nursing Providers|Nurse Practitioner|Adult Health · PALM COAST, FL · NPI 1609316595
Verified facts
What the public records show
CMS Open Payments records show Michelle Libretti, ARNP received $209.86 in general payments during 2025 across 8 reported records.
Bayer Healthcare Pharmaceuticals Inc. accounted for 44.5% of that reported general-payment amount.
The Open Payments records used for this analysis explicitly named 5 associated products.
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 |
|---|---|---|---|---|---|
| Bayer Healthcare Pharmaceuticals Inc. | Unresolved — no canonical attribution shown | $93.44 | 44.5% | 3 | 2025 |
| MAYNE PHARMA COMMERCIAL LLC | Unresolved — no canonical attribution shown | $45.11 | 21.5% | 2 | 2025 |
| Astellas Pharma US Inc | Unresolved — no canonical attribution shown | $25.34 | 12.1% | 1 | 2025 |
| MILLICENT US INC | Unresolved — no canonical attribution shown | $23.07 | 11.0% | 1 | 2025 |
| Exact Sciences Corporation | Unresolved — no canonical attribution shown | $22.90 | 10.9% | 1 | 2025 |
What were the payments for?
Payment categories
| Category | Amount | Records |
|---|---|---|
| Food and Beverage | $209.86 | 8 |
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 |
|---|---|---|---|---|---|
| Mirena Normalized: mirena |
Drug | Bayer Healthcare Pharmaceuticals Inc. | $63.57 | 2 | 2025 |
Source payment records
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| Lynkuet Normalized: lynkuet |
Drug | Bayer Healthcare Pharmaceuticals Inc. | $29.87 | 1 | 2025 |
Source payment records
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| Veozah Normalized: veozah |
Drug | Astellas Pharma US Inc | $25.34 | 1 | 2025 |
Source payment records
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| FEMLYV Normalized: femlyv |
Drug | MILLICENT US INC | $23.07 | 1 | 2025 |
Source payment records
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| The Cologuard Plus Collection Kit Normalized: the cologuard plus collection kit |
Device | Exact Sciences Corporation | $22.90 | 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
No exact normalized or approved-alias overlap was found in the loaded Part D year. This does not mean the doctor never prescribed the product.
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.
No publishable same-company prescribing overlap was found in the loaded Part D year. This does not mean the doctor never prescribed a drug reported elsewhere by a paying company.
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 |
|---|---|---|---|
| Estradiol | Estradiol | 121 | 65 |
| Valacyclovir | Valacyclovir Hcl | 25 | suppressed |
| Fluconazole | Fluconazole | 21 | 16 |
| Clotrimazole-Betamethasone | Clotrimazole/Betamethasone Dip | 19 | 14 |
| Clobetasol Propionate | Clobetasol Propionate | 17 | 13 |
| Premarin | Estrogens, Conjugated | 12 | suppressed |
| Estradiol (Once Weekly) | Estradiol | 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 | $209.86 · 8 records | Bayer Healthcare Pharmaceuticals Inc. | FEMLYV, Lynkuet, Mirena, The Cologuard Plus Collection Kit, Veozah | — | — |
| 2024 | — | — | — | — | Complete |
Questions to ask
Questions you could discuss with your doctor
- 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