Medicare Enrolled
Dr. John Lai, M.D.
Internal Medicine · Daly City, CA
Practice pattern: Clinical Cardiology
— Primarily office-based clinical cardiology
Low-engagement
Very High
DATA COVERAGE
Data in 4 of 4 federal sources
Measures public federal data availability — not provider quality
Informational, not a quality rating.
This page presents federal public records about Dr. Lai from CMS (NPPES, Open Payments, Medicare Provider Utilization, PECOS). It is not medical advice, an endorsement, or a judgment of clinical quality. Always consult the provider directly and a licensed clinician for medical decisions. Read methodology →
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What this data tells you about Dr. Lai
Dr. John Lai is an internal medicine specialist in Daly City, CA, with 19 years of NPI registration. Based on federal Medicare data, Dr. Lai performed 1,199 Medicare services across 736 unique beneficiaries.
Between the years covered by Open Payments, Dr. Lai received a total of $35,073 from 72 pharmaceutical and/or device companies across 1650 individual payments. These payments are legal, publicly disclosed under the federal Sunshine Act, and common in internal medicine. Most payments are for meals and travel — low-value interactions common across virtually all practicing physicians. Patients may wish to discuss these relationships with their provider.
The Data Coverage level for Dr. Lai is Very High — reflecting how much public federal data is available about this provider. Patients are encouraged to use this data as one of several factors when choosing a healthcare provider.
✓ 19 years in practice
▲ Top 26% volume in CA
$35,073 industry payments
Medicare Practice Summary
Medicare Utilization ↗1,199
Medicare services
Top 26% in CA for internal medicine
736
Unique beneficiaries
$84
Avg. Medicare payment
Medicare patients only (65+ / disabled) · How to read this →
~63 Medicare services per year of practice
Top procedures by volume
Ranked by number of services performed for Medicare patients. Avg. submitted charge is what the provider billed; avg. Medicare payment is what CMS paid.
| Procedure | Volume | Avg. paid | Avg. submitted |
|---|---|---|---|
| Office visit, established patient (20-29 min) An office visit for an existing patient lasting between 20 and 29 minutes. The visit involves medical evaluation and management of the patient's condition. |
535 | $71 | $148 |
| Office visit, established patient (30-39 min) A follow-up office visit for an existing patient lasting between 30 and 39 minutes. The visit involves medical evaluation and management of the patient's condition. |
120 | $111 | $212 |
| Nursing facility visit, low complexity A daily follow-up visit for an existing patient in a nursing facility involving straightforward medical decision making. The visit requires at least 15 minutes of time if time is used to determine the level of care. |
110 | $68 | $120 |
| Flu vaccine administration This procedure involves the administration of the influenza virus vaccine. It covers the process of delivering the vaccine to the patient. |
83 | $36 | $45 |
| Annual wellness visit, follow-up A follow-up annual wellness visit that includes a personalized prevention plan of service. |
70 | $153 | $175 |
| Flu vaccine, high-dose High-dose seasonal influenza vaccine for adults aged 65 and older. Contains four times the antigen of standard-dose flu vaccines (60 mcg per strain), split-virus formulation, preservative-free, single-dose syringe. |
56 | $72 | $95 |
| Hospital follow-up visit, moderate complexity Follow-up hospital visit for an existing patient involving moderate medical decision making. The visit requires at least 35 minutes of time spent on the date of service. |
52 | $67 | $135 |
| Office visit, established patient, complex (40-54 min) An office or outpatient visit for an existing patient lasting between 40 and 54 minutes. This level of service is determined by the total time spent on the date of the encounter. |
34 | $165 | $258 |
| Home health plan of care certification Certification by a physician or allowed practitioner for Medicare-covered home health services under a home health plan of care. This includes contacting the home health agency and reviewing reports of patient status required by physicians. |
31 | $47 | $94 |
| Transitional care management, high complexity Coordination of care for a patient transitioning from a short-term hospital stay or other facility to home or another care setting. This service addresses a high-complexity medical problem. |
30 | $256 | $425 |
| Influenza vaccine, quadrivalent, 0.5 ml dosage | 26 | $20 | $95 |
| New patient office visit (45-59 min) An initial office visit for a new patient lasting between 45 and 59 minutes. This code covers the total time spent by the physician or qualified healthcare professional on the date of the encounter. |
21 | $112 | $290 |
| Initial nursing facility care, high complexity An initial visit by a healthcare provider to a patient in a nursing facility involving a high level of medical decision making, lasting at least 45 minutes. |
16 | $147 | $200 |
| New patient office visit (30-44 min) An initial office visit for a new patient lasting between 30 and 44 minutes. This code is used when the total time spent on the date of the encounter falls within this range. |
15 | $72 | $195 |
How to read this data: This reflects Medicare patients only (typically 65+). Payment amounts are what Medicare paid the provider, not your out-of-pocket cost. A higher procedure volume generally indicates more experience with that procedure.
Industry Payment Transparency
Open Payments through 2024 ↗$35,073
Total received (2018-2024)
Avg $5,010/year across 7 years
Top 4% in CA for internal medicine
A higher payment rank reflects disclosed industry relationships (consulting, research, speaking) common among subspecialists — not wrongdoing.
72
Companies
1,650
Individual payments
All payments are legal and publicly reported · Not evidence of wrongdoing · How to interpret →
Payment profile
Industry payments classified by relationship type. Not all payments are equal — research and consulting reflect different relationships than speaking programs or meals.
Meals & Travel
Food, beverages, travel, and lodging — typically low-value
$35,073 (100.0%)
Payment trend by year
Annual totals from pharmaceutical and medical device companies.
2024
$5,454
2023
$5,062
2022
$4,970
2021
$5,516
2020
$4,128
2019
$4,781
2018
$5,162
Payments by company (2024)
Consulting
Speaking
Meals & Travel
Research
AstraZeneca Pharmaceuticals LP
$1,156
Novo Nordisk Inc
$410
Amgen Inc.
$397
Lilly USA, LLC
$377
Boehringer Ingelheim Pharmaceuticals, Inc.
$350
Janssen Pharmaceuticals, Inc
$273
PFIZER INC.
$252
Bayer Healthcare Pharmaceuticals Inc.
$251
Novartis Pharmaceuticals Corporation
$237
CMP Pharma, Inc.
$218
IDORSIA PHARMACEUTICALS US INC
$205
Otsuka America Pharmaceutical, Inc.
$194
GlaxoSmithKline, LLC.
$153
GENZYME CORPORATION
$125
Salix Pharmaceuticals, a division of Bausch Health US, LLC
$116
Xeris Pharmaceuticals, Inc.
$113
ITI, Inc. (d/b/a Intra-Cellular Therapies, Inc.)
$83
Esperion Therapeutics, Inc.
$83
ABBVIE INC.
$72
ZOLL Services LLC (A/K/A ZOLL LifeCor Corp)
$60
Phathom Pharmaceuticals, Inc.
$58
HEARTFLOW, INC.
$43
Smith+Nephew, Inc.
$41
Optinose US, Inc.
$33
Exact Sciences Corporation
$28
Amneal Pharmaceuticals LLC
$24
Kowa Pharmaceuticals America, Inc.
$22
Dexcom, Inc.
$22
Merck Sharp & Dohme LLC
$21
Gilead Sciences, Inc.
$18
IRONWOOD PHARMACEUTICALS, INC
$16
Top 3 companies account for 36.0% of 2024 payments
All-time payments by company (2018-2024) ›
Janssen Pharmaceuticals, Inc
$5,454
Boehringer Ingelheim Pharmaceuticals, Inc.
$4,415
AstraZeneca Pharmaceuticals LP
$3,592
Novo Nordisk Inc
$2,097
Lilly USA, LLC
$1,966
E.R. Squibb & Sons, L.L.C.
$1,302
ZOLL Services LLC (A/K/A ZOLL LifeCor Corp)
$1,098
Novartis Pharmaceuticals Corporation
$1,085
GlaxoSmithKline, LLC.
$1,071
Amgen Inc.
$977
Avanir Pharmaceuticals, Inc.
$915
CMP Pharma, Inc.
$884
Merck Sharp & Dohme Corporation
$692
PFIZER INC.
$679
Gilead Sciences, Inc.
$669
Otsuka America Pharmaceutical, Inc.
$642
Bayer HealthCare Pharmaceuticals Inc.
$569
SANOFI-AVENTIS U.S. LLC
$543
Bayer Healthcare Pharmaceuticals Inc.
$523
Astellas Pharma US Inc
$476
IDORSIA PHARMACEUTICALS US INC
$448
Esperion Therapeutics, Inc.
$435
Amarin Pharma Inc.
$364
Salix Pharmaceuticals, a division of Bausch Health US, LLC
$310
AbbVie Inc.
$244
Merck Sharp & Dohme LLC
$235
Biohaven Pharmaceutical Holding Company Ltd.
$226
ABBVIE INC.
$184
Ironwood Pharmaceuticals, Inc
$173
Eisai Inc.
$153
GENZYME CORPORATION
$148
Xeris Pharmaceuticals, Inc.
$135
Allergan Inc.
$129
Takeda Pharmaceuticals U.S.A., Inc.
$128
Actelion Pharmaceuticals US, Inc.
$125
West-Ward Pharmaceuticals
$121
Hikma Pharmaceuticals USA
$121
Vanda Pharmaceuticals Inc.
$118
IBSA Pharma Inc.
$110
Daiichi Sankyo Inc.
$105
AbbVie, Inc.
$100
Nestle HealthCare Nutrition Inc.
$100
IRONWOOD PHARMACEUTICALS, INC
$97
OptiNose US, Inc.
$96
Biohaven Pharmaceuticals, Inc.
$92
ITI, Inc. (d/b/a Intra-Cellular Therapies, Inc.)
$83
Teva Pharmaceuticals USA, Inc.
$76
EISAI INC.
$76
Phathom Pharmaceuticals, Inc.
$58
HEARTFLOW, INC.
$43
Amneal Pharmaceuticals LLC
$43
Alexion Pharmaceuticals, Inc.
$42
Smith+Nephew, Inc.
$41
Sunovion Pharmaceuticals Inc.
$41
Medtronic, Inc.
$38
Allergan, Inc.
$37
Optinose US, Inc.
$33
Exact Sciences Corporation
$28
Mannkind Corporation
$28
SANOFI PASTEUR INC.
$26
Regeneron Healthcare Solutions, Inc.
$24
Kowa Pharmaceuticals America, Inc.
$22
Dexcom, Inc.
$22
Sun Pharmaceutical Industries Inc.
$22
Abbott Laboratories
$22
Relypsa, Inc.
$21
Genentech USA, Inc.
$21
Seqirus USA Inc
$20
ACADIA Pharmaceuticals Inc
$18
Radius Health, Inc.
$16
MannKind Corporation
$15
Janssen Biotech, Inc.
$14
Top 3 companies account for 38.4% of all-time payments
Associated products mentioned in payments ›
ADVAIR · AFREZZA · AIRSUPRA · AREXVY · AUSTEDO · Aimovig · Amitiza · Atorvaliq · BASAGLAR · BELSOMRA · BEVESPI AEROSPHERE · BREATHTEK · BREO · BREZTRI · BRILINTA · BYDUREON · BYSTOLIC · CAPLYTA · CAROSPIR · CHANTIX · COLLAGENASE SANTYL · COLOGUARD · COMIRNATY · CREON · CYCLOSET · Carospir · Cologuard Collection Kit · Creon · DUPIXENT · Dayvigo · Dexcom G6 Transmitter · ELIQUIS · EMGALITY · ENTRESTO · EVENITY · FANAPT · FARXIGA · FASENRA · FFRct · FLUBLOK QUADRIVALENT · FLUCELVAX QUADRIVALENT · FREESTYLE LIBRE 2 · Fycompa · GARDASIL · GARDASIL 9 · GLYXAMBI · GVOKE HYPOPEN · GVOKE PFS · HUMIRA · INJECTAFER · INSTRUMENTS · INVOKANA · InPen · JANUMET · JANUVIA · JARDIANCE · JENTADUETO · KAPSPARGO · KRYSTEXXA · KYNMOBI · Kerendia · LEQVIO · LICART · LINZESS · LOKELMA · LifeVest · Linzess · MAVYRET · MOUNJARO · MYRBETRIQ · Mitigare · Movantik · Myrbetriq · NEXLETOL · NUEDEXTA · NUPLAZID · NURTEC ODT · Norliqva · Nuedexta · OFEV · Otezla · Ozempic · PAXLOVID · PRALUENT · PREVNAR - 13 · PREVNAR 20 · Prolia · QULIPTA · QUVIVIQ · QVAR · REXULTI · RYBELSUS · RYTARY · Repatha · Rybelsus · SOLIQUA · SOLIQUA 100/33 · SPIRIVA RESPIMAT · STEGLATRO · STIOLTO RESPIMAT · STRENSIQ · SYMBICORT · SYNTHROID · Strensiq · TOUJEO · TRADJENTA · TRELEGY ELLIPTA · TREMFYA · TRULICITY · Tirosint · Tresiba · Tymlos · UBRELVY · Uloric · VESICARE · VIBERZI · VOQUEZNA · VRAYLAR · Vascepa · Veltassa · Veozah · Victoza · Wegovy · Welchol · XARELTO · XIFAXAN · Xhance · Xofluza · Xultophy 100/3.6 · ZENPEP · ZORYVE
Should you be concerned? Payments from pharmaceutical and device companies are legal and common — 57% of U.S. physicians receive at least one. They often reflect legitimate consulting, research, or education. What matters is whether a recommended drug or device appears in your doctor's payment records. If so, consider asking your doctor about it. How to interpret this data →
Most payments (100%) are for meals and travel — low-value interactions that are common across virtually all practicing physicians. Total industry engagement is in the top 4% for internal medicine in CA.
Geographic Context
Internal medicine physicians within 10 mi
3,205
Per 100K population
430.1
County median income
$156,000
Nearest hospital
AHMC SETON MEDICAL CENTER
0.0 mi
0.0 mi
Data Sources
| Provider Registry | ✓ NPPES | Weekly updates |
| Medicare Enrollment | ✓ PECOS | Monthly updates |
| Practice Data | ✓ Medicare Util. | Annual (CY lag) |
| Industry Payments | ✓ Open Payments | CY 2024 |
| Disciplinary History | — Not public | N/A |
This provider has data in 4 of 4 available federal datasets, with a Data Coverage level of Very High. This reflects how much public data is available about a provider. How we calculate this →
Summary
Dr. Lai is a clinical cardiology specialist, with above-average Medicare volume (top 26% in CA), with low-engagement industry engagement in the top 4% of CA peers, with 19 years of NPI registration.
This summary is auto-generated from federal data, describing data availability and patterns. Read our methodology →
Frequently Asked Questions
Is Dr. Lai experienced with office visit, established patient (20-29 min)?
Based on Medicare claims data, Dr. Lai performed 535 office visit, established patient (20-29 min) services. Research suggests that higher procedure volume is often associated with better outcomes, particularly for complex procedures. Note that Medicare data only captures patients aged 65 and older, so the total practice volume across all patients is likely higher.
Does Dr. Lai receive payments from pharmaceutical companies?
Yes. Dr. Lai received a total of $35,073 from 72 companies across 1,650 individual payments. These payments are legal, publicly disclosed under the federal Sunshine Act, and common among physicians — 57% of all U.S. physicians receive at least one industry payment. Patients may wish to ask their doctor about these relationships, especially if a recommended drug or device appears in the payment records.
How do Dr. Lai's costs compare to other internal medicine physicians in Daly City?
Dr. Lai's average Medicare payment per service is $84. Note that these figures represent what Medicare pays, not your out-of-pocket cost, which depends on your specific insurance plan and deductible. Procedure-level data above shows both what was submitted and what Medicare paid for each service type.
What does Data Coverage mean?
Data Coverage (currently Very High for Dr. Lai) measures how much public federal data is available about a provider. It is not a quality rating. A "Very High" or "High" level means the provider has data across multiple federal sources (NPPES, PECOS, Medicare Utilization, Open Payments), indicating a long track record of practice, Medicare participation, and industry disclosure. A "Low" or "Moderate" level may simply mean the provider is newer, does not see Medicare patients, or has not received any industry payments — none of which are inherently negative. Read our full methodology →
Is this data up to date?
Each data source has its own update cycle. Provider registry data (NPPES) is updated weekly. Medicare enrollment (PECOS) is updated monthly. Medicare practice data has a ~2 year lag — the most recent available is typically 2 years prior. Industry payment data (Open Payments) is published annually, usually in June, covering the prior calendar year. We display the data date prominently on each section so you always know how current it is. See our data freshness policy →
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About this page
All data on this page is sourced verbatim from public federal records published by the U.S. Centers for Medicare & Medicaid Services (CMS): NPPES ↗, Open Payments ↗, Medicare Provider Utilization ↗, and PECOS. Publication is mandated by the Physician Payments Sunshine Act (§6002 ACA, 42 U.S.C. §1320a-7h) and the Freedom of Information Act.
This page is not medical advice, an endorsement, a recommendation, or a quality rating. Data Coverage reflects data completeness — how much federal information exists for this provider — not clinical performance, patient outcomes, or quality of care. Always verify information directly with the provider and consult a licensed clinician before making medical decisions.
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