Cynthia Guerra
Nurse Practitioner · Selma, CANPI 1457389215
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 100.0% of the total across 126 separate payments, which is the pattern of a clinician who attends manufacturer presentations rather than one with a consulting arrangement. It is spread thinly across 21 manufacturers, the largest accounting for just 20.2% — the pattern of someone who eats at a lot of different presentations. 2025 is the largest year on record at $3,322, 2.8 times the $1,198 reported in 2022. Among nurse practitioner clinicians in CA with any reported payments, this total sits in the top 5% — high for the specialty, which is a reason to read the composition above rather than the number alone.
Across 126 payments — averaging $66.71 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Salix Pharmaceuticals, A Division Of Bausch Health US, LLC$2K
- Madrigal Pharmaceuticals$913
- Novo Nordisk$904
- AbbVie$850
- Ipsen Biopharmaceuticals, Inc$555
- Johnson & Johnson$513
- plus $3K from 15 others
What the payments were for
- Food & beverage$8,406100%
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 |
|---|---|---|
| Salix Pharmaceuticals, A Division Of Bausch Health US, LLC | 24 | $1,697 |
| Madrigal Pharmaceuticals | 13 | $913 |
| Novo Nordisk | 32 | $904 |
| AbbVie | 10 | $850 |
| Ipsen Biopharmaceuticals, Inc | 6 | $555 |
| Johnson & Johnson | 4 | $513 |
| Lilly USA, LLC | 4 | $360 |
| Abbott | 3 | $358 |
| Ardelyx, Inc. | 7 | $329 |
| Exact Sciences | 3 | $317 |
| Phathom Pharmaceuticals, Inc. | 5 | $284 |
| E.r. Squibb & Sons, L.L.C. | 2 | $244 |
| Aimmune Therapeutics, Inc. | 3 | $226 |
| Gilead | 3 | $216 |
| QOL Medical, LLC | 1 | $122 |
| Regeneron Healthcare Solutions, Inc. | 1 | $118 |
| Pfizer | 1 | $107 |
| Corcept Therapeutics | 1 | $103 |
| GSK | 1 | $96 |
| Scynexis, Inc. | 1 | $77 |
| Genentech USA, Inc. | 1 | $14 |
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.
How this compares
$8,406 in reported general payments places this provider in the 95th percentile of 6,779 nurse practitioner providers in California.
Most prescribed under Part D
| Drug | Claims | Cost to plans & patients |
|---|---|---|
| Dexlansoprazole DrDexlansoprazole | 16 | $2,128 |
| Gavilyte-GPeg3350/Sod Sulf,bicarb,cl/Kcl | 68 | $1,107 |
| Peg-3350 And ElectrolytesPeg3350/Sod Sulf,bicarb,cl/Kcl | 73 | $1,048 |
| Famotidine | 44 | $308 |
| Omeprazole | 41 | $251 |
Paid to pharmacies, not to this prescriber.
Other nurse practitioner in Selma
- Rhonda HewittStanford$917K
- Linda TrinhIrvine$884K
- Denise SinagaNorthridge$728K
- Debbie TaySanta Monica$642K
- Joe GorelickCampbell$638K
- Lynsey LakinArcadia$540K
- Kelly ChoiRancho Cucamonga$483K
- Hamta ZareStanford$428K
- Shawna ChrismanRoseville$425K
- Angelina CollinsSan Diego$356K
Where these figures come from
- Payments: CMS Open Payments, program years 2019–2025 (publication P06302026_06032026).
- Identity: NPPES NPI Registry, July 2026.