Dickran Gulesserian, MD
Internal Medicine · Fresno, CANPI 1336287440
Payments from drug & device makers
Across 810 payments — averaging $22.08 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- AstraZeneca$2K
- Amgen$2K
- AbbVie$974
- Esperion Therapeutics, Inc.$788
- GSK$784
- Novo Nordisk$781
- plus $10K from 54 others
What the payments were for
- Travel & lodging$1471%
- Food & beverage$17,70099%
- Education$330%
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.
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
$17,881 in reported general payments places this provider in the 95th percentile of 13,581 internal medicine providers in California.
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 |
|---|---|---|
| EliquisApixaban | 155 | $140,916 |
| OzempicSemaglutide | 73 | $91,275 |
| Trelegy ElliptaFluticasone/Umeclidin/Vilanter | 73 | $67,125 |
| JardianceEmpagliflozin | 37 | $51,745 |
| TrulicityDulaglutide | 30 | $51,427 |
| Repatha SureclickEvolocumab | 49 | $46,791 |
| MyrbetriqMirabegron | 39 | $39,844 |
| TradjentaLinagliptin | 27 | $35,538 |
| Janumet XrSitagliptin Phos/Metformin Hcl | 47 | $35,318 |
| JanuviaSitagliptin Phosphate | 25 | $34,300 |
| XareltoRivaroxaban | 37 | $33,903 |
| JanumetSitagliptin Phos/Metformin Hcl | 28 | $30,986 |
| FarxigaDapagliflozin Propanediol | 27 | $27,686 |
| MounjaroTirzepatide | 25 | $27,598 |
| VascepaIcosapent Ethyl | 39 | $22,050 |
Paid to pharmacies, not to this prescriber.
Companies that both paid and supply prescribed drugs
These companies both reported payments to this provider and make drugs the provider prescribed under Medicare Part D in 2024. For most specialties this overlap is expected — a cardiologist who is paid by a cardiology drugmaker also treats heart disease. It is shown so the reader can see it, not because it implies anything on its own.
| Company | Paid to this provider | Part D cost of their drugs |
|---|---|---|
| PfizerEliquis, Premarin | $562 | $154,224189 claims |
| Novo NordiskOzempic, Rybelsus | $781 | $111,68285 claims |
| GSKTrelegy Ellipta, Breo Ellipta, Anoro Ellipta | $784 | $91,125111 claims |
| Boehringer IngelheimJardiance, Tradjenta | $600 | $87,28464 claims |
| Lilly USA, LLCTrulicity, Mounjaro | $567 | $79,02655 claims |
| Astellas Pharma US IncMyrbetriq | $175 | $39,84439 claims |
| Johnson & JohnsonXarelto | $761 | $33,90337 claims |
| AbbVieLinzess, Synthroid | $974 | $28,499107 claims |
| AstraZenecaFarxiga | $2,135 | $27,68627 claims |
Reading this fairly. The Part D column is what drug plans and patients paid pharmacies — this provider received none of it, and it reflects how many patients they treat and what those drugs cost. Against peers, this provider's reported payments sit in the 95th percentile of 13,581 internal medicine providers in California.
Other internal medicine in Fresno
- Andrew ChengSouth San Francisco$55.1M
- Joel NeutelTustin$34.9M
- Donald BrandonSan Diego$34M
- William TownerLos Angeles$27.4M
- Rahul AggarwalSan Francisco$24M
- Masoud AzizadNorthridge$21.1M
- Helen StaceyWalnut Creek$20.4M
- Rohit Loombala Jolla$15.1M
- Zeid KayaliColton$14.2M
- Alexandra DrakakiSanta Monica$14.2M
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.