Highest amounts paid to firms lobbying on Medicare in 2003

	Client	Lobbying firm	Total
1.	Pharmaceutical Research And Manufacturers Of America (Phrma)	Alexander Strategy Group	$720,000
2.	Alliance For Quality Nursing Home Care	Barbour Griffith & Rogers, Inc.	$700,000
3.	Biotechnology Industry Organization	Hogan & Hartson, L.L.P.	$680,000
4.	Hoffmann-La Roche, Inc.	Patton Boggs, Llp	$660,000
5.	Pennsylvania, Commonwealth Of	Peyser Associates, Inc.	$650,000
6.	Umass Memorial Health Care, Inc.	Cassidy & Associates, Inc.	$560,000
7.	Puerto Rico Federal Affairs Administration	Winston & Strawn, Llp	$480,000
8.	Council On Radionuclides And Radiopharmaceuticals	Alpine Group, Inc.	$460,000
9.	Sanofi-Synthelabo Inc.	Patton Boggs Llp	$450,000
10.	Pharmaceutical Research And Manufacturers Of America (Phrma)	Hc Associates, Inc.	$440,000