Medicare Enrolled
Dr. Donald Lai, MD
Internal Medicine · Pleasanton, 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. Donald Lai is an internal medicine specialist in Pleasanton, CA, with 20 years of NPI registration. Based on federal Medicare data, Dr. Lai performed 3,010 Medicare services across 1,693 unique beneficiaries.
Between the years covered by Open Payments, Dr. Lai received a total of $2,956 from 22 pharmaceutical and/or device companies across 62 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.
✓ 20 years in practice
▲ Top 10% volume in CA
$2,956 industry payments
Medicare Practice Summary
Medicare Utilization ↗3,010
Medicare services
Top 10% in CA for internal medicine
1,693
Unique beneficiaries
$82
Avg. Medicare payment
Medicare patients only (65+ / disabled) · How to read this →
~150 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 (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. |
1,391 | $106 | $635 |
| Hospital follow-up visit, high complexity Subsequent hospital inpatient or observation care for an existing patient involving high-level medical decision making, with at least 50 minutes total time on the date of the encounter. |
234 | $105 | $369 |
| EKG interpretation and report A standard electrocardiogram test that records the heart's electrical activity using at least 12 leads. The service includes a professional interpretation of the results and a written report. |
160 | $7 | $58 |
| Echocardiogram, transthoracic An ultrasound of the heart that uses color to show blood flow, rate, direction, and valve function. |
158 | $57 | $671 |
| Remote monitoring of implantable heart device, up to 30 days Remote evaluation of an implanted heart or blood vessel monitoring system over a period of up to 30 days. |
150 | $21 | $89 |
| 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. |
145 | $72 | $526 |
| 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. |
123 | $13 | $128 |
| Telehealth originating site facility fee A fee charged by the facility where a patient is located for telehealth services. This covers the use of the site's equipment and staff to connect with a remote provider. |
104 | $21 | $85 |
| 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. |
87 | $137 | $772 |
| Initial hospital admission, high complexity Initial hospital inpatient or observation care for a new patient involving high-level medical decision making, with at least 75 minutes total time on the date of the encounter. |
69 | $147 | $756 |
| Remote pacemaker monitoring, 90 days Remote assessment of a pacemaker system, including single, dual, multiple lead, or leadless devices, performed up to 90 days apart. |
67 | $26 | $140 |
| External EKG monitoring, 8-15 days Continuous external electrocardiogram recording and review over a period of 8 to 15 days to monitor heart rhythm. |
59 | $22 | $230 |
| 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. |
46 | $158 | $791 |
| 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. |
45 | $70 | $270 |
| Pacemaker programming, dual lead system Adjustment and configuration of a dual-lead pacemaker device to ensure proper operation and settings. |
44 | $75 | $267 |
| Exercise or drug-induced heart stress test with ECG A heart stress test performed using exercise or medication while monitoring the electrocardiogram, with physician review of the results. |
30 | $11 | $189 |
| Exercise or drug-induced heart stress test with ECG A heart stress test performed using exercise or medication while monitoring the electrocardiogram under physician supervision and review. |
22 | $69 | $500 |
| Exercise or drug-induced heart stress test with ECG A heart stress test performed using exercise or medication while an electrocardiogram is monitored under physician supervision. |
22 | $16 | $156 |
| Pacemaker programming, single lead Adjustment and testing of a single-lead pacemaker to ensure it functions correctly. |
22 | $64 | $227 |
| Stress echocardiogram with ECG monitoring An ultrasound of the heart performed while monitoring heart rhythm during rest, exercise, or medication-induced stress, followed by a review and report of the findings. |
18 | $206 | $532 |
| Moderate sedation during GI endoscopy Sedation services provided by the physician performing a gastrointestinal endoscopic procedure. This requires an independent trained observer to assist in monitoring the patient. |
14 | $5 | $253 |
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.
9.7% high complexity
3.5% medium
86.8% routine
Industry Payment Transparency
Open Payments through 2024 ↗$2,956
Total received (2018-2024)
Avg $422/year across 7 years
Top 21% in CA for internal medicine
A higher payment rank reflects disclosed industry relationships (consulting, research, speaking) common among subspecialists — not wrongdoing.
22
Companies
62
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
$2,728 (92.3%)
Speaking / Promotional
Speaker programs, honoraria, and industry-sponsored educational events
$228 (7.7%)
Payment trend by year
Annual totals from pharmaceutical and medical device companies.
2024
$342
2023
$414
2022
$226
2021
$300
2020
$106
2019
$1,432
2018
$136
Payments by company (2024)
Consulting
Speaking
Meals & Travel
Research
Boston Scientific Corporation
$133
ZOLL Services LLC (A/K/A ZOLL LifeCor Corp)
$60
Philips North America LLC
$42
Medtronic, Inc.
$40
Cardiac Dimensions, Inc.
$32
Novo Nordisk Inc
$19
ShockWave Medical, Inc
$16
Top 3 companies account for 68.6% of 2024 payments
All-time payments by company (2018-2024) ›
Abbott Laboratories
$1,353
Boston Scientific Corporation
$233
ShockWave Medical, Inc
$200
AstraZeneca Pharmaceuticals LP
$199
Edwards Lifesciences Corporation
$153
HeartFlow, Inc.
$121
ABIOMED
$119
BIOTRONIK INC.
$97
ZOLL Services LLC (A/K/A ZOLL LifeCor Corp)
$78
Medtronic, Inc.
$63
Novartis Pharmaceuticals Corporation
$61
Philips Electronics North America Corporation
$54
Philips North America LLC
$42
Cardiac Dimensions, Inc.
$32
BOSTON SCIENTIFIC CORPORATION
$29
Penumbra, Inc.
$24
Getinge USA Sales, LLC
$22
Novo Nordisk Inc
$19
Roche Diagnostics Corporation
$15
Medtronic Vascular, Inc.
$15
Janssen Pharmaceuticals, Inc
$15
Cardiovascular Systems Inc.
$13
Top 3 companies account for 60.5% of all-time payments
Associated products mentioned in payments ›
(6585) Omniwire · (9266) ELCA · (BQ9) Coronary IVUS · BIOMONITOR · BRILINTA · CARDIOSAVE HYBRID · CD cobas Reagents · Coronary Orbital Atherectomy System · ENTRESTO · FINELINE · GENERAL - BRADY · HeartMate 3 Left Ventricular Dev · Impella · Indigo · LEQVIO · LUX-Dx Insertable Cardiac Monitor · LifeVest · MICRA · Optis Coronary Imaging System · Reveal LINQ · Rivacor · Rybelsus · SAPIEN 3 Ultra RESILIA · SHOCKWAVE IVL SYSTEM WITH THE SHOCKWAVE C2 CORONARY IVL CATHETER · Shockwave IVL System with the Shockwave C2 Coronary IVL Catheter · TYPE B PLUG · VENASEAL · VIGILANT · WATCHMAN · WATCHMAN FLX · XARELTO · Xience Sierra Coronary Stent · Xience V coronary stent system
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 (92%) are for meals and travel — low-value interactions that are common across virtually all practicing physicians.
Geographic Context
Internal medicine physicians within 10 mi
1,648
Per 100K population
99.8
County median income
$126,240
Nearest hospital
STANFORD HEALTH CARE TRI-VALLEY
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 10% in CA), with low-engagement industry engagement, 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. Lai experienced with office visit, established patient (30-39 min)?
Based on Medicare claims data, Dr. Lai performed 1,391 office visit, established patient (30-39 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 $2,956 from 22 companies across 62 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 Pleasanton?
Dr. Lai's average Medicare payment per service is $82. 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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