Pacira Pharmaceuticals Incorporated

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Financial relationships do not necessarily indicate an improper relationship; the data is open to interpretation.

Centers for Medicare & Medicaid Services, Open Payments

These records are submitted to CMS and attested to by the reporting companies. CMS publishes them as reported; this site mirrors them without independent verification.

Figures reflect General Payments this manufacturer or GPO reported to CMS. Research and Ownership/Investment payments are separate datasets and are not included here.

CMS updates this data on an annual cycle, and corrections or successful disputes made at CMS may not yet appear here. The official CMS record is authoritative for the current state.

Page 1 of 218; records 1–50 of 10864 matching records. This page contains 50 records (maximum 50), not the full filtered export. Use the CSV download for all matching records.

IndustryPayments · General Payments

Pacira Pharmaceuticals Incorporated

CMS reporting company ID 100000000135

General Payments, PY2019; Recipient scope: All recipient types; Nature of payment: All payment types

Data edition: cms-20260630-workflow-20261105-v2; CMS publication: 2026-06-30; records imported: 2026-11-05T09:06:52.159882+00:00

Page 1 of 218; records 1–50 of 10864 matching records. This page contains 50 records (maximum 50), not the full filtered export.

Filtered page: https://industrypayments.org/company/100000000135?year=2019&recipient=all#records-h

CMS source: https://openpaymentsdata.cms.gov/dataset/4e54dd6c-30f8-4f86-86a7-3c109a89528e

Cite these filtered records

The citation includes this program year, filters, data edition, and page of results.

Plain
Pacira Pharmaceuticals Incorporated, CMS reporting company ID 100000000135. General Payments, PY2019; Recipient scope: All recipient types; Nature of payment: All payment types. Data edition: cms-20260630-workflow-20261105-v2; CMS publication: 2026-06-30; records imported: 2026-11-05T09:06:52.159882+00:00. Page 1 of 218; records 1–50 of 10864 matching records. This page contains 50 records (maximum 50), not the full filtered export. IndustryPayments. https://industrypayments.org/company/100000000135?year=2019&recipient=all#records-h. Source: https://openpaymentsdata.cms.gov/dataset/4e54dd6c-30f8-4f86-86a7-3c109a89528e.
APA 7
IndustryPayments. (2026). Pacira Pharmaceuticals Incorporated, CMS reporting company ID 100000000135. General Payments, PY2019; Recipient scope: All recipient types; Nature of payment: All payment types. Data edition: cms-20260630-workflow-20261105-v2; CMS publication: 2026-06-30; records imported: 2026-11-05T09:06:52.159882+00:00. Page 1 of 218; records 1–50 of 10864 matching records. This page contains 50 records (maximum 50), not the full filtered export. [Filtered data set page]. https://industrypayments.org/company/100000000135?year=2019&recipient=all#records-h. Source: https://openpaymentsdata.cms.gov/dataset/4e54dd6c-30f8-4f86-86a7-3c109a89528e.
Bluebook
Pacira Pharmaceuticals Incorporated, CMS reporting company ID 100000000135, IndustryPayments, General Payments, PY2019; Recipient scope: All recipient types; Nature of payment: All payment types (Data edition: cms-20260630-workflow-20261105-v2; CMS publication: 2026-06-30; records imported: 2026-11-05T09:06:52.159882+00:00). Page 1 of 218; records 1–50 of 10864 matching records. This page contains 50 records (maximum 50), not the full filtered export. Source: https://openpaymentsdata.cms.gov/dataset/4e54dd6c-30f8-4f86-86a7-3c109a89528e. https://industrypayments.org/company/100000000135?year=2019&recipient=all#records-h.

Centers for Medicare & Medicaid Services, Open Payments

Citation formats are provided for reference; check the requirements of your publication.

Payment records · PY2019

Date, newest first, then reporting company; values as published by CMS.

General Payments · PY2019 · All recipient types · CMS publication 2026-06-30

10,864 matching records · $7,258,266.60 reported total · 0 disputed

Nature of payment: All payment types

Records imported here (UTC).

Link to these filtered records · CMS source dataset ↗

Download all 10,864 matching records (CSV)

CSV includes CMS record IDs, source and publication dates, the data edition, and a link to these filters. Formula-like text cells are prefixed with an apostrophe for spreadsheet safety.

Showing records 1–50 of 10,864.

Recipient Paying entityAmountDate Nature of paymentDispute statusPublication flagsPublished Record IDSource
PEDRO F FRANCO
Physician / non-physician practitioner
Pacira Pharmaceuticals Incorporated $19.4012/31/2019 Food and Beverage No dispute reported Delay: No
Change: UNCHANGED
06/30/2026 692934705 CMS
JEFFREY C GADSDEN
Physician / non-physician practitioner
Pacira Pharmaceuticals Incorporated $19.1712/30/2019 Food and Beverage No dispute reported Delay: No
Change: UNCHANGED
06/30/2026 692935215 CMS
MARGARET C HOLTZ
Physician / non-physician practitioner
Pacira Pharmaceuticals Incorporated $19.1712/30/2019 Food and Beverage No dispute reported Delay: No
Change: UNCHANGED
06/30/2026 692937645 CMS
LEWIS T LADOCSI
Physician / non-physician practitioner
Pacira Pharmaceuticals Incorporated $24.9612/30/2019 Food and Beverage No dispute reported Delay: No
Change: UNCHANGED
06/30/2026 692939759 CMS
JEFFREY C GADSDEN
Physician / non-physician practitioner
Pacira Pharmaceuticals Incorporated $88.1412/29/2019 Food and Beverage No dispute reported Delay: No
Change: UNCHANGED
06/30/2026 692935213 CMS
MARGARET C HOLTZ
Physician / non-physician practitioner
Pacira Pharmaceuticals Incorporated $88.1412/29/2019 Food and Beverage No dispute reported Delay: No
Change: UNCHANGED
06/30/2026 692937643 CMS
JOSHUA A URBAN
Physician / non-physician practitioner
Pacira Pharmaceuticals Incorporated $88.1412/29/2019 Food and Beverage No dispute reported Delay: No
Change: UNCHANGED
06/30/2026 692949313 CMS
RICHARD ABRAHAM MEADERS
Physician / non-physician practitioner
Pacira Pharmaceuticals Incorporated $23.7912/27/2019 Food and Beverage No dispute reported Delay: No
Change: UNCHANGED
06/30/2026 692941733 CMS
JONATHAN MC THREADGILL
Physician / non-physician practitioner
Pacira Pharmaceuticals Incorporated $23.7912/27/2019 Food and Beverage No dispute reported Delay: No
Change: UNCHANGED
06/30/2026 692948987 CMS
HESHAM A ELSHARKAWY
Physician / non-physician practitioner
Pacira Pharmaceuticals Incorporated $1,200.0012/26/2019 Consulting Fee No dispute reported Delay: No
Change: UNCHANGED
06/30/2026 692934131 CMS
SUMEET GARG
Physician / non-physician practitioner
Pacira Pharmaceuticals Incorporated $2,000.0012/26/2019 Compensation for services other than consulting, including serving as faculty or as a speaker at a venue other than a continuing education program No dispute reported Delay: No
Change: UNCHANGED
06/30/2026 692935333 CMS
JERROLD LERMAN
Physician / non-physician practitioner
Pacira Pharmaceuticals Incorporated $1,800.0012/26/2019 Compensation for services other than consulting, including serving as faculty or as a speaker at a venue other than a continuing education program No dispute reported Delay: No
Change: UNCHANGED
06/30/2026 692940191 CMS
GARY S SCHWARTZ
Physician / non-physician practitioner
Pacira Pharmaceuticals Incorporated $2,880.0012/26/2019 Consulting Fee No dispute reported Delay: No
Change: UNCHANGED
06/30/2026 692946117 CMS
GARY S SCHWARTZ
Physician / non-physician practitioner
Pacira Pharmaceuticals Incorporated $43.7512/26/2019 Food and Beverage No dispute reported Delay: No
Change: UNCHANGED
06/30/2026 692946119 CMS
GARY S SCHWARTZ
Physician / non-physician practitioner
Pacira Pharmaceuticals Incorporated $52.4112/26/2019 Travel and Lodging No dispute reported Delay: No
Change: UNCHANGED
06/30/2026 692946121 CMS
GARY S SCHWARTZ
Physician / non-physician practitioner
Pacira Pharmaceuticals Incorporated $462.5212/26/2019 Travel and Lodging No dispute reported Delay: No
Change: UNCHANGED
06/30/2026 692946123 CMS
GARY S SCHWARTZ
Physician / non-physician practitioner
Pacira Pharmaceuticals Incorporated $275.6012/26/2019 Travel and Lodging No dispute reported Delay: No
Change: UNCHANGED
06/30/2026 692946125 CMS
GARY S SCHWARTZ
Physician / non-physician practitioner
Pacira Pharmaceuticals Incorporated $93.9112/26/2019 Travel and Lodging No dispute reported Delay: No
Change: UNCHANGED
06/30/2026 692946127 CMS
GARY S SCHWARTZ
Physician / non-physician practitioner
Pacira Pharmaceuticals Incorporated $63.6912/26/2019 Travel and Lodging No dispute reported Delay: No
Change: UNCHANGED
06/30/2026 692946129 CMS
GARY S SCHWARTZ
Physician / non-physician practitioner
Pacira Pharmaceuticals Incorporated $17.7812/26/2019 Food and Beverage No dispute reported Delay: No
Change: UNCHANGED
06/30/2026 692946131 CMS
GARY S SCHWARTZ
Physician / non-physician practitioner
Pacira Pharmaceuticals Incorporated $16.6912/26/2019 Food and Beverage No dispute reported Delay: No
Change: UNCHANGED
06/30/2026 692946133 CMS
LORAN SOLIMAN
Physician / non-physician practitioner
Pacira Pharmaceuticals Incorporated $4,600.0012/26/2019 Compensation for services other than consulting, including serving as faculty or as a speaker at a venue other than a continuing education program No dispute reported Delay: No
Change: UNCHANGED
06/30/2026 692947531 CMS
SANTHANAM SURESH
Physician / non-physician practitioner
Pacira Pharmaceuticals Incorporated $2,800.0012/26/2019 Compensation for services other than consulting, including serving as faculty or as a speaker at a venue other than a continuing education program No dispute reported Delay: No
Change: UNCHANGED
06/30/2026 692948117 CMS
STEPHEN D GOERZ
Physician / non-physician practitioner
Pacira Pharmaceuticals Incorporated $11.2112/25/2019 Food and Beverage No dispute reported Delay: No
Change: UNCHANGED
06/30/2026 692936101 CMS
TAN D LY
Physician / non-physician practitioner
Pacira Pharmaceuticals Incorporated $11.2112/25/2019 Food and Beverage No dispute reported Delay: No
Change: UNCHANGED
06/30/2026 692940715 CMS
SABRY S AYAD
Physician / non-physician practitioner
Pacira Pharmaceuticals Incorporated $4,800.0012/23/2019 Compensation for services other than consulting, including serving as faculty or as a speaker at a venue other than a continuing education program No dispute reported Delay: No
Change: UNCHANGED
06/30/2026 692929727 CMS
SABRY S AYAD
Physician / non-physician practitioner
Pacira Pharmaceuticals Incorporated $600.0012/23/2019 Compensation for services other than consulting, including serving as faculty or as a speaker at a venue other than a continuing education program No dispute reported Delay: No
Change: UNCHANGED
06/30/2026 692929729 CMS
JOHN J BAWDUNIAK
Physician / non-physician practitioner
Pacira Pharmaceuticals Incorporated $11.4012/23/2019 Food and Beverage No dispute reported Delay: No
Change: UNCHANGED
06/30/2026 692930149 CMS
YITZHAK BELSH
Physician / non-physician practitioner
Pacira Pharmaceuticals Incorporated $1,160.0012/23/2019 Compensation for services other than consulting, including serving as faculty or as a speaker at a venue other than a continuing education program No dispute reported Delay: No
Change: UNCHANGED
06/30/2026 692930275 CMS
AARON A BERG
Physician / non-physician practitioner
Pacira Pharmaceuticals Incorporated $66.2312/23/2019 Travel and Lodging No dispute reported Delay: No
Change: UNCHANGED
06/30/2026 692930581 CMS
AARON A BERG
Physician / non-physician practitioner
Pacira Pharmaceuticals Incorporated $24.7012/23/2019 Food and Beverage No dispute reported Delay: No
Change: UNCHANGED
06/30/2026 692930583 CMS
AARON A BERG
Physician / non-physician practitioner
Pacira Pharmaceuticals Incorporated $9.3712/23/2019 Food and Beverage No dispute reported Delay: No
Change: UNCHANGED
06/30/2026 692930585 CMS
AARON A BERG
Physician / non-physician practitioner
Pacira Pharmaceuticals Incorporated $62.1412/23/2019 Travel and Lodging No dispute reported Delay: No
Change: UNCHANGED
06/30/2026 692930587 CMS
ROBERTO CARLOS BLANCO DUARTE
Physician / non-physician practitioner
Pacira Pharmaceuticals Incorporated $2,465.0012/23/2019 Compensation for services other than consulting, including serving as faculty or as a speaker at a venue other than a continuing education program No dispute reported Delay: No
Change: UNCHANGED
06/30/2026 692930913 CMS
KENNETH M BURSON
Physician / non-physician practitioner
Pacira Pharmaceuticals Incorporated $11.8312/23/2019 Food and Beverage No dispute reported Delay: No
Change: UNCHANGED
06/30/2026 692931585 CMS
RICHARD M CHUDACOFF
Physician / non-physician practitioner
Pacira Pharmaceuticals Incorporated $456.6012/23/2019 Travel and Lodging No dispute reported Delay: No
Change: UNCHANGED
06/30/2026 692932387 CMS
ROBERT M FROHM
Physician / non-physician practitioner
Pacira Pharmaceuticals Incorporated $22.2612/23/2019 Travel and Lodging No dispute reported Delay: No
Change: UNCHANGED
06/30/2026 692934819 CMS
ROBERT M FROHM
Physician / non-physician practitioner
Pacira Pharmaceuticals Incorporated $7.2912/23/2019 Travel and Lodging No dispute reported Delay: No
Change: UNCHANGED
06/30/2026 692934821 CMS
ROBERT M FROHM
Physician / non-physician practitioner
Pacira Pharmaceuticals Incorporated $22.5912/23/2019 Travel and Lodging No dispute reported Delay: No
Change: UNCHANGED
06/30/2026 692934823 CMS
ROBERT M FROHM
Physician / non-physician practitioner
Pacira Pharmaceuticals Incorporated $529.5912/23/2019 Travel and Lodging No dispute reported Delay: No
Change: UNCHANGED
06/30/2026 692934825 CMS
MYLES GART
Physician / non-physician practitioner
Pacira Pharmaceuticals Incorporated $3,780.0012/23/2019 Compensation for services other than consulting, including serving as faculty or as a speaker at a venue other than a continuing education program No dispute reported Delay: No
Change: UNCHANGED
06/30/2026 692935451 CMS
VALENTINE A GIBSON
Physician / non-physician practitioner
Pacira Pharmaceuticals Incorporated $2,465.0012/23/2019 Compensation for services other than consulting, including serving as faculty or as a speaker at a venue other than a continuing education program No dispute reported Delay: No
Change: UNCHANGED
06/30/2026 692936009 CMS
JEFFREY J GONZALES
Physician / non-physician practitioner
Pacira Pharmaceuticals Incorporated $5,040.0012/23/2019 Compensation for services other than consulting, including serving as faculty or as a speaker at a venue other than a continuing education program No dispute reported Delay: No
Change: UNCHANGED
06/30/2026 692936291 CMS
MARGARET C HOLTZ
Physician / non-physician practitioner
Pacira Pharmaceuticals Incorporated $3,675.0012/23/2019 Compensation for services other than consulting, including serving as faculty or as a speaker at a venue other than a continuing education program No dispute reported Delay: No
Change: UNCHANGED
06/30/2026 692937641 CMS
STEVEN D MCCARUS
Physician / non-physician practitioner
Pacira Pharmaceuticals Incorporated $3,700.0012/23/2019 Compensation for services other than consulting, including serving as faculty or as a speaker at a venue other than a continuing education program No dispute reported Delay: No
Change: UNCHANGED
06/30/2026 692941447 CMS
STEVEN D MCCARUS
Physician / non-physician practitioner
Pacira Pharmaceuticals Incorporated $2,960.0012/23/2019 Compensation for services other than consulting, including serving as faculty or as a speaker at a venue other than a continuing education program No dispute reported Delay: No
Change: UNCHANGED
06/30/2026 692941449 CMS
JAMES B MUELLER
Physician / non-physician practitioner
Pacira Pharmaceuticals Incorporated $236.5912/23/2019 Travel and Lodging No dispute reported Delay: No
Change: UNCHANGED
06/30/2026 692942733 CMS
JAMES B MUELLER
Physician / non-physician practitioner
Pacira Pharmaceuticals Incorporated $151.2912/23/2019 Travel and Lodging No dispute reported Delay: No
Change: UNCHANGED
06/30/2026 692942735 CMS
JAMES B MUELLER
Physician / non-physician practitioner
Pacira Pharmaceuticals Incorporated $126.6112/23/2019 Travel and Lodging No dispute reported Delay: No
Change: UNCHANGED
06/30/2026 692942737 CMS
JAMES B MUELLER
Physician / non-physician practitioner
Pacira Pharmaceuticals Incorporated $12.5712/23/2019 Food and Beverage No dispute reported Delay: No
Change: UNCHANGED
06/30/2026 692942739 CMS

Practitioner overview · all loaded program years

43,748 providers listed 97,902 records General Payments

General Payments to practitioners — all loaded program years

  • Category: General Payments
  • Program years: 2019, 2020, 2021, 2022, 2023, 2024, 2025
  • Record count: 97,902
  • Providers listed: 43,748

Financial relationships do not necessarily indicate an improper relationship; the data is open to interpretation.

Figures reflect General Payments this manufacturer or GPO reported to CMS. Research and Ownership/Investment payments are separate datasets and are not included here.

Coverage: program years 2019–2025, General Payments only, reported to physicians and non-physician practitioners. Payments to teaching hospitals are not included in these practitioner figures. Each figure is labeled with its category and program year; categories are never combined.

Practitioner payments by program year

Program yearReportedRecordsProvidersDetail
PY2019 $6,958,987.77 10,839 6,421 This company in PY2019 →
PY2020 $3,801,211.58 4,246 2,603 This company in PY2020 →
PY2021 $4,095,449.48 11,445 6,761 This company in PY2021 →
PY2022 $4,704,712.95 15,025 8,634 This company in PY2022 →
PY2023 $5,182,226.03 17,677 10,178 This company in PY2023 →
PY2024 $4,694,068.30 18,272 10,680 This company in PY2024 →
PY2025 $4,911,379.74 20,398 12,520 This company in PY2025 →

By recipient specialty (222)

Sorted by name; identical names by identifier.

Allopathic & Osteopathic Physicians 150 specialties 24,741 providers
Chiropractic Providers 8 specialties 75 providers
Dental Providers 14 specialties 1,428 providers
Eye and Vision Services Providers 1 specialty 14 providers
Nursing Service Providers 12 specialties 93 providers
Physician Assistants & Advanced Practice Nursing Providers 31 specialties 15,404 providers
Podiatric Medicine & Surgery Service Providers 6 specialties 1,091 providers

Providers listed (43,748)

Sorted by name; identical names by identifier.

ProviderSpecialtyStateRecords reported by this company
A JAY STAUB Allopathic & Osteopathic Physicians|Obstetrics & Gynecology TX 1
A MICHAEL MOHEIMANI Allopathic & Osteopathic Physicians|Orthopaedic Surgery CA 2
A REZA MIREMADI — OH 1
AADIL TOOR Dental Providers|Dentist|General Practice VA 1
AAKASH DEEP GUPTA Dental Providers|Dentist|General Practice TX 1
AAKASH H GAJJAR Allopathic & Osteopathic Physicians|Colon & Rectal Surgery TX 1
AAKASH SHAH Allopathic & Osteopathic Physicians|Emergency Medicine NY 1
AAKASH THAKRAL Allopathic & Osteopathic Physicians|Physical Medicine & Rehabilitation CO 1
AAKASH V AGARWALA Allopathic & Osteopathic Physicians|Anesthesiology CA 3
AALAMJOT BHULLER Physician Assistants & Advanced Practice Nursing Providers|Nurse Anesthetist, Certified Registered VA 3
AALI M SHAH Allopathic & Osteopathic Physicians|Anesthesiology|Pediatric Anesthesiology MO 1
AALOK SAHAI — AZ 1
AALOK SUNIL SHAH Allopathic & Osteopathic Physicians|Family Medicine|Sports Medicine FL 2
AAMER AGHA Allopathic & Osteopathic Physicians|Internal Medicine|Gastroenterology TX 5
AAMIR MUSHTAQ RAI Allopathic & Osteopathic Physicians|Anesthesiology|Pain Medicine TX 2
AARATHI R RAO Dental Providers|Dentist|Oral and Maxillofacial Surgery WI 1
AARIKA MIDDLETON Physician Assistants & Advanced Practice Nursing Providers|Physician Assistant KS 1
AARON A BERG Allopathic & Osteopathic Physicians|Anesthesiology MN 706
AARON A DORCY Physician Assistants & Advanced Practice Nursing Providers|Nurse Anesthetist, Certified Registered TX 1
AARON A JONES Physician Assistants & Advanced Practice Nursing Providers|Nurse Anesthetist, Certified Registered TN 1
AARON A LINDEN Physician Assistants & Advanced Practice Nursing Providers|Physician Assistant TX 1
AARON ALCORN Physician Assistants & Advanced Practice Nursing Providers|Nurse Anesthetist, Certified Registered FL 1
AARON ALEXANDER JOINER Allopathic & Osteopathic Physicians|Orthopaedic Surgery|Sports Medicine AL 2
AARON B HOUSE Allopathic & Osteopathic Physicians|Surgery KY 2
AARON B MCCOY Physician Assistants & Advanced Practice Nursing Providers|Nurse Anesthetist, Certified Registered OK 1
AARON BARROW Allopathic & Osteopathic Physicians|Orthopaedic Surgery|Orthopaedic Trauma FL 1
AARON BENNER Allopathic & Osteopathic Physicians|Radiology|Diagnostic Radiology NE 1
AARON BUCKLAND Allopathic & Osteopathic Physicians|Orthopaedic Surgery|Orthopaedic Surgery of the Spine NY 1
AARON C RAYFORD Physician Assistants & Advanced Practice Nursing Providers|Physician Assistant TX 2
AARON CANNON Allopathic & Osteopathic Physicians|Anesthesiology OH 2
AARON CHAMBERLAIN Allopathic & Osteopathic Physicians|Orthopaedic Surgery|Orthopaedic Surgery of the Spine UT 2
AARON CHRISTOPHER BOLLICH Physician Assistants & Advanced Practice Nursing Providers|Physician Assistant|Medical LA 3
AARON D KULWICKI Allopathic & Osteopathic Physicians|Surgery|Vascular Surgery OH 1
AARON D LYBARGER Physician Assistants & Advanced Practice Nursing Providers|Nurse Anesthetist, Certified Registered ID 2
AARON D SCHRAYER Allopathic & Osteopathic Physicians|Orthopaedic Surgery|Orthopaedic Trauma TX 1
AARON DANIEL LEIS Allopathic & Osteopathic Physicians|Anesthesiology IN 4
AARON DEAN HOLVERSON Physician Assistants & Advanced Practice Nursing Providers|Nurse Anesthetist, Certified Registered IN 1
AARON DONALD LEE Allopathic & Osteopathic Physicians|Family Medicine IL 1
AARON DREES Physician Assistants & Advanced Practice Nursing Providers|Nurse Anesthetist, Certified Registered ID 1
AARON EGELKRAUT Physician Assistants & Advanced Practice Nursing Providers|Nurse Anesthetist, Certified Registered NE 1
AARON ELMORE Physician Assistants & Advanced Practice Nursing Providers|Nurse Anesthetist, Certified Registered TN 1
AARON EVEN Allopathic & Osteopathic Physicians|Anesthesiology WA 1
AARON F SUMMERS Allopathic & Osteopathic Physicians|Anesthesiology MN 1
AARON FOLSOM — TX 1
AARON G MURRELL Allopathic & Osteopathic Physicians|Anesthesiology MO 1
AARON G WATTERS Allopathic & Osteopathic Physicians|Pediatrics IN 5
AARON GJ ZONDLO Physician Assistants & Advanced Practice Nursing Providers|Nurse Anesthetist, Certified Registered WI 1
AARON GLENN TUCKE Dental Providers|Dentist|Oral and Maxillofacial Surgery IL 1
AARON HANSEN Allopathic & Osteopathic Physicians|Anesthesiology CO 1
AARON HANYU-DEUTMEYER Allopathic & Osteopathic Physicians|Physical Medicine & Rehabilitation|Pain Medicine LA 4