Donald Pacheco
Orthopaedic Surgery · Fresno, CANPI 1942297320
Payments from drug & device makers
Across 275 payments — averaging $37.04 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- AstraZeneca$3K
- Boehringer Ingelheim$2K
- Amgen$1K
- Lilly USA, LLC$818
- AbbVie$665
- Bayer$398
- plus $3K from 27 others
What the payments were for
- Food & beverage$10,187100%
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 |
|---|---|---|
| AstraZeneca | 68 | $2,744 |
| Boehringer Ingelheim | 46 | $1,607 |
| Amgen(2 entities) | 37 | $1,115 |
| Lilly USA, LLC | 15 | $818 |
| AbbVie | 22 | $665 |
| Bayer | 14 | $398 |
| Novo Nordisk | 9 | $359 |
| GSK | 5 | $280 |
| Phathom Pharmaceuticals, Inc. | 2 | $250 |
| Pfizer | 14 | $247 |
| Otsuka America Pharmaceutical, Inc. | 3 | $162 |
| Agios Pharmaceuticals, Inc. | 2 | $160 |
| Neurocrine Biosciences, Inc. | 1 | $140 |
| Madrigal Pharmaceuticals | 1 | $124 |
| Aimmune Therapeutics, Inc. | 1 | $124 |
| Eisai Inc. | 1 | $122 |
| Regeneron Healthcare Solutions, Inc. | 1 | $108 |
| Abiomed | 1 | $101 |
| Ironwood Pharmaceuticals, Inc | 5 | $95 |
| Daiichi Sankyo Inc. | 5 | $94 |
| Vanda Pharmaceuticals Inc. | 4 | $92 |
| Novartis | 3 | $67 |
| Shield Therapeutics Inc | 3 | $63 |
| Biohaven Pharmaceuticals, Inc. | 3 | $54 |
| Nevro Corp. | 1 | $35 |
| Exact Sciences | 1 | $26 |
| Biogen | 1 | $23 |
| Biohaven Pharmaceutical Holding Company Ltd. | 1 | $22 |
| Qiagen, LLC | 1 | $21 |
| Abbott | 1 | $19 |
| Esperion Therapeutics, Inc. | 1 | $18 |
| Mylan Specialty L.p. | 1 | $16 |
| Kowa Pharmaceuticals America, Inc. | 1 | $16 |
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
$10,187 in reported general payments places this provider in the 70th percentile of 1,808 orthopaedic surgery providers in California.
Most prescribed under Part D
| Drug | Claims | Cost to plans & patients |
|---|---|---|
| JardianceEmpagliflozin | 175 | $207,768 |
| OzempicSemaglutide | 124 | $166,788 |
| FarxigaDapagliflozin Propanediol | 72 | $88,681 |
| TrulicityDulaglutide | 55 | $78,915 |
| Trelegy ElliptaFluticasone/Umeclidin/Vilanter | 77 | $72,570 |
| EliquisApixaban | 39 | $49,188 |
| LinzessLinaclotide | 42 | $46,147 |
| JanuviaSitagliptin Phosphate | 38 | $38,509 |
| TradjentaLinagliptin | 29 | $26,703 |
| EntrestoSacubitril/Valsartan | 15 | $15,338 |
| Repatha SyringeEvolocumab | 11 | $14,850 |
| VascepaIcosapent Ethyl | 28 | $14,784 |
| MyrbetriqMirabegron | 18 | $10,641 |
| Atorvastatin Calcium | 833 | $9,137 |
| Basaglar Kwikpen U-100Insulin Glargine,hum.Rec.Anlog | 28 | $8,645 |
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 |
|---|---|---|
| Boehringer IngelheimJardiance, Tradjenta | $1,607 | $234,471204 claims |
| Novo NordiskOzempic | $359 | $166,788124 claims |
| AstraZenecaFarxiga | $2,744 | $88,68172 claims |
| Lilly USA, LLCTrulicity | $818 | $78,91555 claims |
| GSKTrelegy Ellipta | $280 | $72,57077 claims |
| PfizerEliquis | $247 | $49,18839 claims |
| AbbVieLinzess, Synthroid | $665 | $47,65257 claims |
| NovartisEntresto | $67 | $15,33815 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 70th percentile of 1,808 orthopaedic surgery providers in California.
Other orthopaedic surgery in Fresno
- Eric HansonFresno$1.8M
- Connor TellesFresno$1M
- Julia LeeFresno$588K
- Bradford HackArcadia$18.3M
- Robert GorabOrange$14.5M
- Kelly VinceLos Angeles$9.6M
- Stephen HowellSacramento$9.4M
- Thomas CoonRed Bluff$9.2M
- Peter NewtonSan Diego$7M
- Nirav AminPlacentia$5.8M
Where these figures come from
- Payments: CMS Open Payments, program years 2019–2025 (publication P06302026_06032026).
- Identity: NPPES NPI Registry, July 2026.