Anand Karnad, MD
Medical Oncology · San Antonio, TXNPI 1023011624
Payments from drug & device makers
What this record shows
This record is dominated by food and beverage: $208 of the $312 with a category attached, or 66.8%. 4 manufacturers reported payments, led by Amgen at 49.3% of the total. Reporting peaked in 2019 at $125 and has fallen 65.4% since, to $43 in 2025. That places this record below the midpoint for medical oncology clinicians in TX, where the typical reported total is $4,372.
Across 8 payments — averaging $38.97 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Amgen$154
- AstraZeneca$73
- Genentech USA, Inc.$55
- Apellis Pharmaceuticals, Inc.$30
Across 32 payments — averaging $2593.08 each. Payments tied to a research study. These frequently flow through the physician to a hospital or research institution rather than to the physician personally.
- F. Hoffmann-la Roche AG$27K
- Novartis$24K
- Janssen Research & Development, LLC$16K
- Merck$16K
What the payments were for
- Food & beverage$20867%
- Education$10433%
Most of this is food and beverage — typically meals provided during product presentations at a clinic or hospital. Nationally that is the single largest category of reported payments by count.
General payments by program year
Who reported the general payments
Companies are grouped under their corporate parent — a single manufacturer often files under several CMS reporting entities. Research and ownership payments are counted separately and are not in this table.
| Company | Payments | Total |
|---|---|---|
| Amgen | 2 | $154 |
| AstraZeneca(2 entities) | 2 | $73 |
| Genentech USA, Inc. | 3 | $55 |
| Apellis Pharmaceuticals, Inc. | 1 | $30 |
What the payments were tied to
Products named in the reported payments. Only payments of $100 or more are attributed here — the typical reported payment nationally is a meal worth about $16, and listing those product-by-product would be noise.
- Vectibix$125
How this compares
$312 in reported general payments places this provider in the 15th percentile of 495 medical oncology providers in Texas.
Medicare billing
What this is not: this is the amount Original Medicare Part B allowed for services this provider billed in 2024. It is not their income. It excludes Medicare Advantage — now more than half of all Medicare enrollment — along with Medicaid and all commercial insurance, and it is gross practice revenue before staff, rent, supplies and malpractice premiums. CMS also suppresses any figure covering ten or fewer patients, so low-volume providers appear smaller than they are.
Most prescribed under Part D
| Drug | Claims | Cost to plans & patients |
|---|---|---|
| ImbruvicaIbrutinib | 23 | $343,069 |
| RevlimidLenalidomide | 12 | $251,709 |
| JakafiRuxolitinib Phosphate | 11 | $210,508 |
| BesremiRopeginterferon Alfa-2b-Njft | 11 | $186,678 |
| SprycelDasatinib | 14 | $130,758 |
| PromactaEltrombopag Olamine | 15 | $120,989 |
| EliquisApixaban | 63 | $50,838 |
| XareltoRivaroxaban | 48 | $47,671 |
| Imatinib Mesylate | 23 | $9,519 |
| PradaxaDabigatran Etexilate Mesylate | 12 | $2,339 |
| Fentanyl | 12 | $2,176 |
| Hydroxyurea | 59 | $976 |
| Hydrocodone-AcetaminophenHydrocodone/Acetaminophen | 29 | $926 |
| Morphine Sulfate ErMorphine Sulfate | 15 | $444 |
| Ibuprofen | 15 | $49 |
Paid to pharmacies, not to this prescriber.
Other medical oncology in San Antonio
- Vijay GunugantiSan Antonio$1.5M
- Virginia KaklamaniSan Antonio$787K
- John SarantopoulosSan Antonio$588K
- Sukeshi AroraSan Antonio$188K
- Anthony TolcherSan Antonio$125K
- Zohra NooruddinSan Antonio$113K
- Moshe LevyDallas$5.1M
- Suresh RatnamMcAllen$3M
- Roy HerbstHouston$1.9M
- Andrew WhiteleyDallas$1.7M
Where these figures come from
- Payments: CMS Open Payments, program years 2019–2025 (publication P06302026_06032026).
- Billing: Medicare Physician & Other Practitioners, data year 2024. Original Medicare Part B only.
- Identity: NPPES NPI Registry, July 2026.