Medicare Enrolled
Dr. Robin Spiering, MD
Internal Medicine · El Cajon, 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. Spiering 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. Spiering
Dr. Robin Spiering is an internal medicine specialist in El Cajon, CA, with 20 years of NPI registration. Based on federal Medicare data, Dr. Spiering performed 6,169 Medicare services across 3,422 unique beneficiaries.
Between the years covered by Open Payments, Dr. Spiering received a total of $11,386 from 54 pharmaceutical and/or device companies across 517 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. Spiering 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.
✓ 20 years in practice
▲ Top 4% volume in CA
$11,386 industry payments
Medicare Practice Summary
Medicare Utilization ↗6,169
Medicare services
Top 4% in CA for internal medicine
3,422
Unique beneficiaries
$66
Avg. Medicare payment
Medicare patients only (65+ / disabled) · How to read this →
~308 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 |
|---|---|---|---|
| Remote patient monitoring device, 30 days Initial setup of devices for remote monitoring of body functions with daily data transmission or alerts. This service covers the first 30 days of the monitoring period. |
1,001 | $41 | $142 |
| 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. |
876 | $69 | $146 |
| 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. |
871 | $96 | $216 |
| Remote patient monitoring management, 20 min/month Management based on results from remote vital sign monitoring for the first 20 minutes per calendar month. |
591 | $41 | $110 |
| Remote vital sign monitoring management, each additional 20 minutes This code covers the time spent by a provider managing patient data from remote vital sign monitoring devices. It applies to each additional 20-minute increment beyond the initial monthly service period. |
536 | $34 | $100 |
| Annual wellness visit, follow-up A follow-up annual wellness visit that includes a personalized prevention plan of service. |
405 | $138 | $274 |
| Annual depression screening | 292 | $20 | $25 |
| Electrocardiogram (EKG), 12-lead A standard heart rhythm test using at least 12 leads to record electrical activity. A healthcare provider interprets the results and provides a written report. |
268 | $11 | $83 |
| Chronic care management, first 20 min/month This service covers the first 20 minutes of clinical staff time directed by a healthcare professional each calendar month to manage chronic conditions. |
108 | $52 | $80 |
| Complex chronic care management, first 60 minutes This service involves clinical staff time directed by a healthcare professional to manage two or more chronic conditions over a calendar month. It covers the first 60 minutes of this coordinated care effort. |
102 | $106 | $150 |
| Chronic care management, first 30 minutes This service covers the initial 30 minutes of care coordination for patients with two or more chronic conditions. It is provided personally by a healthcare professional each calendar month. |
101 | $69 | $150 |
| Telephone medical discussion, 21-30 minutes A telephone conversation with a physician lasting between 21 and 30 minutes. This code covers the time spent discussing medical matters over the phone. |
91 | $100 | $216 |
| Echocardiogram, transthoracic An ultrasound of the heart that uses color to show blood flow, rate, direction, and valve function. |
83 | $161 | $708 |
| Quadrivalent influenza vaccine, cell culture-derived A flu shot that protects against four strains of the influenza virus. It is produced using cell culture technology rather than traditional egg-based methods. |
81 | $32 | $78 |
| Flu vaccine administration This procedure involves the administration of the influenza virus vaccine. It covers the process of delivering the vaccine to the patient. |
81 | $33 | $40 |
| Ultrasound of head and neck blood flow, bilateral An ultrasound exam that uses sound waves to visualize and assess blood flow in the vessels of both the head and the neck. |
73 | $169 | $400 |
| Ultrasound of arm and leg arteries This procedure uses sound waves to create images of the blood vessels in the arms and legs. It allows healthcare providers to examine the structure and blood flow within these arteries. |
61 | $68 | $130 |
| Destruction of precancerous skin growth, 1 Removal of a single precancerous skin growth. This procedure destroys abnormal skin cells to prevent them from developing into cancer. |
59 | $56 | $170 |
| Pneumonia vaccine administration This procedure involves the injection of a vaccine to protect against pneumococcal disease. It is administered by a healthcare provider. |
42 | $33 | $40 |
| Annual alcohol misuse screening, 5 to 15 minutes | 42 | $20 | $45 |
| Destruction of precancerous skin growths, 2-14 This procedure involves the removal or destruction of two to fourteen precancerous skin lesions. It is performed to eliminate abnormal skin cells that have the potential to develop into cancer. |
41 | $6 | $40 |
| Pneumococcal conjugate vaccine (PCV20) An intramuscular injection of the 20-valent pneumococcal conjugate vaccine. It is used to protect against diseases caused by Streptococcus pneumoniae bacteria. |
39 | $243 | $248 |
| 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. |
38 | $71 | $240 |
| 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. |
36 | $238 | $325 |
| Expiratory airflow and volume test A test that measures the amount of air you can exhale and the speed at which you can breathe it out. It evaluates lung function by assessing expiratory airflow and volume. |
32 | $20 | $77 |
| Telephone medical discussion, 11-20 minutes A phone conversation with a physician lasting between 11 and 20 minutes. |
32 | $68 | $146 |
| Transitional care management services, moderate complexity Services provided to coordinate care during the transition from an inpatient or other facility setting back to the community. This includes follow-up and management of a health problem of at least moderate complexity. |
27 | $169 | $250 |
| Ultrasound of leg arteries or grafts An imaging test that uses sound waves to create pictures of the blood vessels in the legs or any surgical grafts present. |
23 | $217 | $450 |
| Smoking cessation counseling, 4-10 minutes A brief counseling session focused on helping patients quit smoking and tobacco use. The provider spends 4 to 10 minutes discussing strategies and support for cessation. |
19 | $16 | $75 |
| Office visit, established patient (10-19 min) An office visit for an existing patient lasting 10 to 19 minutes. The visit involves medical evaluation and management of the patient's condition. |
18 | $46 | $89 |
| Ear wax removal by washing This procedure involves the removal of impacted ear wax using a washing technique. |
17 | $14 | $90 |
| Routine 12-lead ECG screening A standard 12-lead electrocardiogram performed as part of an initial preventive physical examination. The service includes both the performance of the test and the physician's interpretation and report. |
17 | $8 | $85 |
| Complete ultrasound of aorta, vena cava, groin vessels or bypass grafts A complete ultrasound exam of the aorta, vena cava, groin vessels, or bypass grafts. This imaging test uses sound waves to visualize these blood vessels. |
15 | $155 | $350 |
| Ultrasound of arm or leg veins An ultrasound exam of the veins in the arm or leg. The test uses sound waves to check blood flow and may include compression and other maneuvers. |
14 | $167 | $395 |
| Hemoglobin A1c test (diabetes monitoring) A blood test that measures your average blood sugar levels over the past two to three months. |
13 | $10 | $25 |
| Initial preventive physical examination, new Medicare beneficiary A comprehensive preventive health visit for new Medicare beneficiaries during their first 12 months of enrollment. The service is conducted as a face-to-face visit and is limited to preventive care. |
13 | $176 | $325 |
| Annual wellness visit, initial visit A yearly appointment to review your health and create a personalized prevention plan. This initial visit focuses on preventive care and health assessment. |
11 | $176 | $300 |
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.
1.6% high complexity
2.8% medium
95.6% routine
Industry Payment Transparency
Open Payments through 2024 ↗$11,386
Total received (2018-2024)
Avg $1,627/year across 7 years
Top 9% in CA for internal medicine
A higher payment rank reflects disclosed industry relationships (consulting, research, speaking) common among subspecialists — not wrongdoing.
54
Companies
517
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
$11,374 (99.9%)
Speaking / Promotional
Speaker programs, honoraria, and industry-sponsored educational events
$12 (0.1%)
Payment trend by year
Annual totals from pharmaceutical and medical device companies.
2024
$1,392
2023
$1,982
2022
$1,530
2021
$1,971
2020
$1,287
2019
$1,660
2018
$1,563
Payments by company (2024)
Consulting
Speaking
Meals & Travel
Research
AstraZeneca Pharmaceuticals LP
$327
ABBVIE INC.
$237
Lilly USA, LLC
$203
GlaxoSmithKline, LLC.
$153
SI-BONE, INC.
$145
Esperion Therapeutics, Inc.
$66
Amgen Inc.
$39
Merck Sharp & Dohme LLC
$37
Novo Nordisk Inc
$30
Boehringer Ingelheim Pharmaceuticals, Inc.
$24
E.R. Squibb & Sons, L.L.C.
$23
Phathom Pharmaceuticals, Inc.
$21
Sumitomo Pharma America, Inc.
$21
Salix Pharmaceuticals, a division of Bausch Health US, LLC
$19
Verity Pharmaceuticals Inc.
$18
Azurity Pharmaceuticals, Inc.
$16
Nevro Corp.
$14
Top 3 companies account for 55.1% of 2024 payments
All-time payments by company (2018-2024) ›
GlaxoSmithKline, LLC.
$1,643
AstraZeneca Pharmaceuticals LP
$1,301
Amgen Inc.
$823
Novo Nordisk Inc
$805
Lilly USA, LLC
$765
Boehringer Ingelheim Pharmaceuticals, Inc.
$647
AbbVie Inc.
$591
PFIZER INC.
$540
Esperion Therapeutics, Inc.
$483
Merck Sharp & Dohme Corporation
$422
ABBVIE INC.
$405
SANOFI-AVENTIS U.S. LLC
$362
Novartis Pharmaceuticals Corporation
$327
Amarin Pharma Inc.
$292
Boston Scientific Corporation
$213
SI-BONE, INC.
$145
Astellas Pharma US Inc
$124
Allergan Inc.
$121
Actelion Pharmaceuticals US, Inc.
$120
Merz North America, Inc.
$109
Allergan, Inc.
$82
Bayer HealthCare Pharmaceuticals Inc.
$71
Janssen Pharmaceuticals, Inc
$69
Takeda Pharmaceuticals U.S.A., Inc.
$66
Salix Pharmaceuticals, a division of Bausch Health US, LLC
$62
E.R. Squibb & Sons, L.L.C.
$61
Merck Sharp & Dohme LLC
$57
BOSTON SCIENTIFIC CORPORATION
$57
Biohaven Pharmaceuticals, Inc.
$53
Philips Electronics North America Corporation
$52
Nevro Corp.
$51
Eisai Inc.
$45
Daiichi Sankyo Inc.
$39
IDORSIA PHARMACEUTICALS US INC
$36
Tactile Systems Technology Inc
$29
Abbott Laboratories
$21
Medtronic Vascular, Inc.
$21
Phathom Pharmaceuticals, Inc.
$21
Sumitomo Pharma America, Inc.
$21
Alnylam Pharmaceuticals Inc.
$18
IBSA Pharma Inc.
$18
Verity Pharmaceuticals Inc.
$18
Sanofi Pasteur Inc.
$17
Pulmonx Corporation
$17
AbbVie, Inc.
$16
Azurity Pharmaceuticals, Inc.
$16
ASSERTIO THERAPEUTICS, Inc.
$16
Mannkind Corporation
$16
Noden Pharma USA Inc
$16
Gilead Sciences, Inc.
$16
SANOFI PASTEUR INC.
$13
Regeneron Healthcare Solutions, Inc.
$12
Metacel Pharmaceuticals LLC
$11
Ferring Pharmaceuticals Inc.
$11
Top 3 companies account for 33.1% of all-time payments
Associated products mentioned in payments ›
(7999) SRC Undivided · AFREZZA · AIMOVIG · AIRSUPRA · ANORO · ANORO ELLIPTA · AREXVY · AXIOS · Aimovig · Amitiza · Androgel · BASAGLAR · BELSOMRA · BREO · BREZTRI · BYSTOLIC · CHANTIX · CHARTIS CATHETER · Dayvigo · Descovy · ELIQUIS · EMGALITY · ENTRESTO · EVENITY · FARXIGA · FLUZONE HIGH-DOSE · FLUZONE QUADRIVALENT · FREESTYLE LIBRE 2 · Flexitouch Plus · GARDASIL · GEMTESA · GIVLAARI · Gralise · HORIZANT · INJECTAFER · JANUVIA · JARDIANCE · Kerendia · LINZESS · LYRICA · MOUNJARO · MYRBETRIQ · NEXLETOL · NEXLIZET · NOCDURNA · NURTEC ODT · Omnia · Otezla · Ozempic · Ozobax · PAXLOVID · PNEUMOVAX 23 · PRALUENT · PREVNAR - 13 · PREVNAR 13 · PREVNAR 20 · QULIPTA · QUVIVIQ · RYBELSUS · Repatha · Rybelsus · SHINGRIX · SOLIQUA 100/33 · SPIRIVA RESPIMAT · STIOLTO RESPIMAT · SYMBICORT · Saxenda · Senza · Senza Spinal Cord Stimulation System · TEKTURNA · TOUJEO · TRADJENTA · TRELEGY ELLIPTA · TRULICITY · Tirosint · Tlando · Tresiba · Trintellix · UBRELVY · UPTRAVI · VOQUEZNA · VRAYLAR · Vascepa · Victoza · WATCHMAN · WATCHMAN Access System · WATCHMAN FLX · XARELTO · XIFAXAN · Xeomin · iPro2
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 9% for internal medicine in CA.
Geographic Context
Internal medicine physicians within 10 mi
1,634
Per 100K population
49.8
County median income
$102,285
Nearest hospital
GROSSMONT HOSPITAL
3.3 mi
3.3 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. Spiering is a clinical cardiology specialist, with above-average Medicare volume (top 4% in CA), with low-engagement industry engagement in the top 9% of CA peers, with 20 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. Spiering experienced with remote patient monitoring device, 30 days?
Based on Medicare claims data, Dr. Spiering performed 1,001 remote patient monitoring device, 30 days 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. Spiering receive payments from pharmaceutical companies?
Yes. Dr. Spiering received a total of $11,386 from 54 companies across 517 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. Spiering's costs compare to other internal medicine physicians in El Cajon?
Dr. Spiering's average Medicare payment per service is $66. 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. Spiering) 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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