Earl Fernando, MD
Family Medicine · Fresno, CANPI 1033255021
Payments from drug & device makers
Across 612 payments — averaging $21.25 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- GSK$2K
- AstraZeneca$2K
- Johnson & Johnson$1K
- Boehringer Ingelheim$1K
- Amgen$1K
- Bayer$728
- plus $5K from 28 others
What the payments were for
- Food & beverage$12,90899%
- Education$951%
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 |
|---|---|---|
| GSK | 102 | $1,524 |
| AstraZeneca | 52 | $1,502 |
| Johnson & Johnson | 57 | $1,451 |
| Boehringer Ingelheim | 70 | $1,447 |
| Amgen | 44 | $1,300 |
| Bayer | 23 | $728 |
| Lilly USA, LLC | 25 | $624 |
| Mannkind Corporation | 27 | $559 |
| Novo Nordisk | 26 | $474 |
| Amarin Pharma, Inc. | 36 | $461 |
| Sanofi-aventis U.S. LLC | 26 | $433 |
| Merck | 15 | $415 |
| Salix Pharmaceuticals, A Division Of Bausch Health US, LLC | 27 | $372 |
| Sunovion Pharmaceuticals Inc. | 29 | $366 |
| Dexcom, Inc. | 4 | $323 |
| Ironwood Pharmaceuticals, Inc | 11 | $188 |
| Neurocrine Biosciences, Inc. | 2 | $131 |
| Pfizer | 5 | $97 |
| Nevro Corp. | 3 | $84 |
| ITI, Inc. (d/b/a Intra-cellular Therapies, Inc.) | 4 | $68 |
| Novartis | 4 | $67 |
| Abbott | 3 | $61 |
| Mylan Specialty L.p. | 3 | $61 |
| Takeda Pharmaceuticals U.S.A., Inc. | 2 | $56 |
| Idorsia Pharmaceuticals US Inc | 3 | $54 |
| AbbVie | 1 | $26 |
| Sumitomo Pharma America, Inc. | 1 | $24 |
| Avanir Pharmaceuticals, Inc. | 1 | $22 |
| Regeneron Healthcare Solutions, Inc. | 1 | $18 |
| Corcept Therapeutics | 1 | $16 |
| Astellas Pharma US Inc | 1 | $16 |
| Osiris Therapeutics Inc. | 1 | $13 |
| Bausch & Lomb, A Division Of Bausch Health US, LLC | 1 | $12 |
| Smith+Nephew | 1 | $11 |
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
$13,003 in reported general payments places this provider in the 95th percentile of 10,533 family 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 |
|---|---|---|
| JardianceEmpagliflozin | 348 | $423,497 |
| RybelsusSemaglutide | 174 | $296,859 |
| TrulicityDulaglutide | 91 | $144,528 |
| TradjentaLinagliptin | 120 | $128,504 |
| LinzessLinaclotide | 102 | $124,052 |
| XareltoRivaroxaban | 78 | $92,277 |
| KerendiaFinerenone | 60 | $81,621 |
| Omeprazole-Sodium BicarbonateOmeprazole/Sodium Bicarbonate | 34 | $79,720 |
| FarxigaDapagliflozin Propanediol | 72 | $79,023 |
| Trelegy ElliptaFluticasone/Umeclidin/Vilanter | 63 | $63,135 |
| MounjaroTirzepatide | 49 | $61,705 |
| VascepaIcosapent Ethyl | 82 | $58,684 |
| OzempicSemaglutide | 42 | $54,888 |
| Icosapent Ethyl | 118 | $48,536 |
| JanuviaSitagliptin Phosphate | 49 | $48,343 |
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, Trijardy Xr, Synjardy Xr | $1,447 | $583,112493 claims |
| Novo NordiskRybelsus, Ozempic, Xultophy 100-3.6 | $474 | $360,879227 claims |
| Lilly USA, LLCTrulicity, Mounjaro | $624 | $206,232140 claims |
| AbbVieLinzess | $26 | $124,052102 claims |
| AstraZenecaFarxiga, Breztri Aerosphere | $1,502 | $109,470116 claims |
| Johnson & JohnsonXarelto | $1,451 | $92,27778 claims |
| BayerKerendia | $728 | $81,62160 claims |
| GSKTrelegy Ellipta, Breo Ellipta | $1,524 | $78,39197 claims |
| MerckJanuvia, Belsomra | $415 | $64,22187 claims |
| PfizerEliquis | $97 | $41,54138 claims |
| Sumitomo Pharma America, Inc.Gemtesa | $24 | $36,70634 claims |
| NovartisEntresto | $67 | $33,76026 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 10,533 family medicine providers in California.
Other family medicine in Fresno
- Amina HaggagNorthridge$112.8M
- Steven ReynoldsLong Beach$53M
- Rizwana MohseniLake Forest$26.7M
- Daniel JohnsonSan Diego$15.7M
- Stacey LayleSan Diego$14.8M
- Apinya VutikullirdCypress$14.3M
- Hanid AudishSpring Valley$13.6M
- Augusto FocilOxnard$12.6M
- Jack VuLong Beach$10.1M
- Suzanne FussellOxnard$8.9M
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.