Medicare Enrolled
Dr. Douglas Fletcher, MD
Critical Care Medicine · Middletown, NY
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. Fletcher 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. Fletcher
Dr. Douglas Fletcher is a critical care medicine specialist in Middletown, NY, with 20 years of NPI registration. Based on federal Medicare data, Dr. Fletcher performed 2,094 Medicare services across 1,265 unique beneficiaries.
Between the years covered by Open Payments, Dr. Fletcher received a total of $8,308 from 38 pharmaceutical and/or device companies across 490 individual payments. These payments are legal, publicly disclosed under the federal Sunshine Act, and common in critical care 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. Fletcher 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 9% volume in NY
$8,308 industry payments
Medicare Practice Summary
Medicare Utilization ↗2,094
Medicare services
Top 9% in NY for critical care medicine
1,265
Unique beneficiaries
$73
Avg. Medicare payment
Medicare patients only (65+ / disabled) · How to read this →
~105 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. |
686 | $103 | $140 |
| 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. |
261 | $71 | $99 |
| Blood draw (venipuncture) Insertion of a needle into a vein to collect a blood sample. |
137 | $7 | $8 |
| Lung volume test using sensors A test that measures the amount of air in the lungs using sensors. |
97 | $46 | $64 |
| Lung volume test using gas dilution or washout A test that measures the amount of air in your lungs by using a gas dilution or washout method. |
97 | $37 | $49 |
| Pulmonary gas exchange test A test to examine how well the lungs exchange gases. |
97 | $46 | $64 |
| Spirometry test before and after medication A test that measures the amount of air you can exhale and the speed of your breathing before and after taking a medication. |
96 | $33 | $44 |
| Comprehensive metabolic blood panel A blood test that measures a group of chemicals, including glucose, electrolytes, and kidney and liver function markers. |
94 | $10 | $11 |
| Complete blood count (CBC) with differential An automated laboratory test that measures the levels of red blood cells, white blood cells, and platelets in the blood, including a breakdown of the different types of white blood cells. |
88 | $8 | $8 |
| 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. |
65 | $134 | $182 |
| Chest X-ray, 2 views An X-ray imaging test of the chest that captures two different angles to visualize the lungs, heart, and chest wall. |
60 | $18 | $26 |
| CT scan of chest, without contrast A computed tomography scan of the chest area that uses X-rays to create detailed images without the use of contrast dye. |
59 | $70 | $98 |
| COVID-19 immunoassay detection test A laboratory test that uses an immunoassay method to detect the presence of severe acute respiratory syndrome coronavirus 2 (COVID-19) through direct visual observation. |
41 | $41 | $110 |
| Critical care, first 30-74 min Emergency medical care for a critically ill or injured patient lasting between 30 and 74 minutes. This service involves direct patient care and medical decision making to stabilize the patient. |
41 | $179 | $670 |
| Lipid panel (cholesterol and triglycerides) A blood test that measures cholesterol and triglyceride levels. |
34 | $13 | $14 |
| 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. |
31 | $101 | $128 |
| Vitamin B-12 level test A blood test that measures the amount of vitamin B-12 in your body. |
21 | $15 | $17 |
| Sleep study in sleep lab (age 6+) An overnight test conducted in a sleep laboratory to monitor sleep patterns and bodily functions in patients aged 6 years or older. |
18 | $534 | $676 |
| 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. |
17 | $86 | $123 |
| Hemoglobin A1c test (diabetes monitoring) A blood test that measures your average blood sugar levels over the past two to three months. |
16 | $10 | $11 |
| Thyroid stimulating hormone (TSH) test A blood test that measures the level of thyroid stimulating hormone to evaluate thyroid function. |
14 | $16 | $17 |
| Sleep study with continuous airway pressure, age 6+ A sleep study conducted in a sleep lab that monitors breathing and other body functions while administering continuous airway pressure. This test is performed on patients aged 6 years or older. |
13 | $559 | $708 |
| Flu vaccine administration This procedure involves the administration of the influenza virus vaccine. It covers the process of delivering the vaccine to the patient. |
11 | $29 | $30 |
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 ↗$8,308
Total received (2018-2024)
Avg $1,187/year across 7 years
Top 14% in NY for critical care medicine
A higher payment rank reflects disclosed industry relationships (consulting, research, speaking) common among subspecialists — not wrongdoing.
38
Companies
490
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
$8,212 (98.8%)
Speaking / Promotional
Speaker programs, honoraria, and industry-sponsored educational events
$96 (1.2%)
Payment trend by year
Annual totals from pharmaceutical and medical device companies.
2024
$957
2023
$1,541
2022
$1,005
2021
$749
2020
$813
2019
$1,763
2018
$1,480
Payments by company (2024)
Consulting
Speaking
Meals & Travel
Research
GENZYME CORPORATION
$334
Amgen Inc.
$132
Regeneron Healthcare Solutions, Inc.
$118
GlaxoSmithKline, LLC.
$85
AstraZeneca Pharmaceuticals LP
$60
Avadel CNS Pharmaceuticals, LLC
$54
PFIZER INC.
$38
Actelion Pharmaceuticals US, Inc.
$35
Lilly USA, LLC
$32
Inspire Medical Systems, Inc.
$26
Novartis Pharmaceuticals Corporation
$26
Tactile Systems Technology Inc
$18
Top 3 companies account for 61.0% of 2024 payments
All-time payments by company (2018-2024) ›
GlaxoSmithKline, LLC.
$1,428
GENZYME CORPORATION
$1,235
AstraZeneca Pharmaceuticals LP
$1,056
Regeneron Healthcare Solutions, Inc.
$819
Boehringer Ingelheim Pharmaceuticals, Inc.
$395
Novartis Pharmaceuticals Corporation
$389
Actelion Pharmaceuticals US, Inc.
$361
Genentech USA, Inc.
$321
Sunovion Pharmaceuticals Inc.
$287
Grifols USA, LLC
$226
Mylan Specialty L.P.
$208
Amgen Inc.
$193
PFIZER INC.
$117
JAZZ PHARMACEUTICALS INC.
$116
Jazz Pharmaceuticals Inc.
$109
Bayer Healthcare Pharmaceuticals Inc.
$96
Mallinckrodt Enterprises LLC
$88
Electromed, Inc.
$87
Avadel CNS Pharmaceuticals, LLC
$87
Novo Nordisk Inc
$78
Shire North American Group Inc
$74
Circassia Pharmaceuticals Inc
$71
Takeda Pharmaceuticals U.S.A., Inc.
$70
Mallinckrodt Hospital Products Inc.
$61
Lilly USA, LLC
$45
Mallinckrodt LLC
$42
Baxter Healthcare
$39
Inspire Medical Systems, Inc.
$26
Teva Pharmaceuticals USA, Inc.
$26
E.R. Squibb & Sons, L.L.C.
$24
Axsome Therapeutics, Inc.
$19
Exeltis, USA Inc.
$18
Tactile Systems Technology Inc
$18
Bayer HealthCare Pharmaceuticals Inc.
$18
Biohaven Pharmaceuticals, Inc.
$16
Philips Electronics North America Corporation
$16
Advanced Respiratory, Inc
$15
Insmed, Inc.
$14
Top 3 companies account for 44.8% of all-time payments
Associated products mentioned in payments ›
(8874) inCourage · ACTHAR · AIRSUPRA · ANORO · ANORO ELLIPTA · AREXVY · Adempas · Arikayce · BEVESPI AEROSPHERE · BREO · BREZTRI · BREZTRI AEROSPHERE · CHANTIX · CINQAIR · CUVITRU · DUPIXENT · DUPIXENT DUPILUMAB INJECTION · ELIQUIS · EMGALITY · ENTRESTO · Esbriet · FASENRA · Flexitouch Plus · GLASSIA · Hillrom - Life 2000 Ventilation System · Hillrom - Vest System Model 105 Home Care · INSPIRE · LONHALA MAGNAIR · LUMRYZ · Life 2000 Ventilation System · NUCALA · NURTEC ODT · OFEV · OFIRMEV · OPSUMIT · OPSUMIT MACITENTAN · Otezla · Ozempic · PREVNAR - 13 · PREVNAR 13 · PREVNAR 20 · PURIFIED CORTROPHIN GEL · Perforomist · Prolastin-C Liquid · Repatha · SMARTVEST · SPIRIVA RESPIMAT · STIOLTO RESPIMAT · SUNOSI · SYMBICORT · Sunosi · TEZSPIRE · TRELEGY ELLIPTA · TUDORZA PRESSAIR · Tresiba · UPTRAVI · UTIBRON · UTIBRON NEOHALER · Utibron · XOLAIR · XYREM · XYWAV · Xolair · Xyrem · YUPELRI · Yupelri · ZEPBOUND
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 (99%) are for meals and travel — low-value interactions that are common across virtually all practicing physicians.
Geographic Context
Critical care medicines within 10 mi
13
Per 100K population
3.2
County median income
$96,497
Nearest hospital
GARNET HEALTH 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. Fletcher is a clinical cardiology specialist, with above-average Medicare volume (top 9% in NY), with low-engagement industry engagement in the top 14% of NY 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. Fletcher experienced with office visit, established patient (30-39 min)?
Based on Medicare claims data, Dr. Fletcher performed 686 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. Fletcher receive payments from pharmaceutical companies?
Yes. Dr. Fletcher received a total of $8,308 from 38 companies across 490 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. Fletcher's costs compare to other critical care medicines in Middletown?
Dr. Fletcher's average Medicare payment per service is $73. 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. Fletcher) 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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