Esmeralda Arreola
Family Medicine · Fresno, CANPI 1881689388
Payments from drug & device makers
Across 251 payments — averaging $17.84 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- AstraZeneca$666
- Novo Nordisk$651
- Lilly USA, LLC$642
- Boehringer Ingelheim$514
- Pfizer$202
- GSK$194
- plus $2K from 29 others
What the payments were for
- Food & beverage$4,459100%
- Education$180%
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 | 36 | $666 |
| Novo Nordisk | 45 | $651 |
| Lilly USA, LLC | 42 | $642 |
| Boehringer Ingelheim | 28 | $514 |
| Pfizer | 12 | $202 |
| GSK | 11 | $194 |
| Kowa Pharmaceuticals America, Inc. | 8 | $148 |
| AbbVie(2 entities) | 8 | $144 |
| Abbott | 5 | $128 |
| Exact Sciences | 5 | $97 |
| Sanofi-aventis U.S. LLC | 4 | $90 |
| Amgen | 4 | $84 |
| Astellas Pharma US Inc | 4 | $82 |
| Dynavax Technologies Corporation | 4 | $81 |
| Takeda Pharmaceuticals U.S.A., Inc. | 4 | $66 |
| Sanofi Pasteur Inc. | 3 | $65 |
| Viiv Healthcare Company | 2 | $59 |
| Hologic Sales And Service, LLC | 2 | $57 |
| Bayer | 2 | $57 |
| Biogen | 1 | $49 |
| Johnson & Johnson | 3 | $49 |
| Biohaven Pharmaceutical Holding Company Ltd. | 2 | $46 |
| Xeris Pharmaceuticals, Inc. | 2 | $42 |
| Dexcom, Inc. | 2 | $40 |
| Biohaven Pharmaceuticals, Inc. | 1 | $32 |
| Teva Pharmaceuticals USA, Inc. | 2 | $31 |
| Merck | 1 | $23 |
| Philips North America LLC | 1 | $22 |
| Esperion Therapeutics, Inc. | 1 | $21 |
| Otsuka America Pharmaceutical, Inc. | 1 | $19 |
| Phathom Pharmaceuticals, Inc. | 1 | $19 |
| Ironwood Pharmaceuticals, Inc | 1 | $17 |
| Seqirus USA Inc | 1 | $15 |
| Idorsia Pharmaceuticals US Inc | 1 | $13 |
| Lupin Inc. | 1 | $12 |
How this compares
$4,477 in reported general payments places this provider in the 90th 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 | 19 | $28,881 |
| OzempicSemaglutide | 23 | $26,454 |
| Breo ElliptaFluticasone/Vilanterol | 17 | $12,562 |
| EliquisApixaban | 21 | $10,717 |
| Repatha SureclickEvolocumab | 11 | $7,179 |
| Tresiba Flextouch U-100Insulin Degludec | 11 | $5,893 |
| BreynaBudesonide/Formoterol Fumarate | 35 | $4,846 |
| Varenicline Tartrate | 12 | $3,988 |
| Albuterol Sulfate HfaAlbuterol Sulfate | 93 | $2,739 |
| Atorvastatin Calcium | 233 | $2,562 |
| Levothyroxine Sodium | 157 | $2,150 |
| Celecoxib | 18 | $2,071 |
| Gabapentin | 89 | $1,688 |
| Losartan Potassium | 145 | $1,550 |
| Rosuvastatin Calcium | 72 | $1,395 |
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 | $514 | $28,88119 claims |
| Novo NordiskOzempic | $651 | $26,45423 claims |
| GSKBreo Ellipta | $194 | $12,56217 claims |
| PfizerEliquis | $202 | $10,71721 claims |
| Sanofi-aventis U.S. LLCLantus | $90 | $80012 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 90th 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.