Guy Piegari, MD
Cardiovascular Disease · Wyomissing, PANPI 1659361095
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 97.0% of the total across 244 separate payments, which is the pattern of a clinician who attends manufacturer presentations rather than one with a consulting arrangement. 24 manufacturers reported payments, led by Edwards Lifesciences at 36.3% of the total. Reporting peaked in 2019 at $2,130 and has fallen 93.6% since, to $136 in 2025.
Across 244 payments — averaging $32.23 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Edwards Lifesciences$3K
- Amarin Pharma, Inc.$737
- Johnson & Johnson$628
- Amgen$619
- Pfizer$380
- AstraZeneca$377
- plus $2K from 18 others
Across 41 payments — averaging $6277.24 each. Payments tied to a research study. These frequently flow through the physician to a hospital or research institution rather than to the physician personally.
- Abbott$166K
- Microvention, Inc.$91K
What the payments were for
- Consulting fees$2003%
- Food & beverage$7,63197%
- 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.
| Company | Payments | Total |
|---|---|---|
| Edwards Lifesciences | 81 | $2,853 |
| Amarin Pharma, Inc. | 41 | $737 |
| Johnson & Johnson | 24 | $628 |
| Amgen | 24 | $619 |
| Pfizer | 10 | $380 |
| AstraZeneca | 3 | $377 |
| Medtronic(2 entities) | 4 | $298 |
| E.r. Squibb & Sons, L.L.C. | 7 | $275 |
| Microvention, Inc. | 1 | $200 |
| ZOLL Services LLC (a/k/a ZOLL Lifecor Corp) | 12 | $195 |
| Novartis | 8 | $172 |
| Boehringer Ingelheim | 3 | $150 |
| Boston Scientific | 3 | $138 |
| Silk Road Medical, Inc. | 1 | $125 |
| Bayer | 1 | $125 |
| Cardinal Health 200 LLC | 4 | $103 |
| Avinger Inc. | 1 | $87 |
| Regeneron Healthcare Solutions, Inc. | 3 | $86 |
| Cordis US CORP. | 3 | $84 |
| Abbott | 4 | $77 |
| Abiomed | 2 | $50 |
| Shockwave Medical, Inc | 1 | $47 |
| Chiesi USA, Inc. | 2 | $41 |
| Merck | 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.
- FARXIGA$377
- XARELTO$350
- Repatha$245
- Edwards SAPIEN 3 Transcatheter Heart Valve$211
- CoreValve Evolut$203
- ENROUTE Transcarotid Neuroprotection System$125
- ENROUTE Transcarotid Stent$125
- Vascepa$125
- Kerendia$125
- VYNDAQEL$124
- JARDIANCE$124
- CAMZYOS$123
- ELUVIA$118
How this compares
$7,864 in reported general payments places this provider in the 80th percentile of 1,250 cardiovascular disease providers in Pennsylvania.
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 | 267 | $295,665 |
| XareltoRivaroxaban | 215 | $248,554 |
| EntrestoSacubitril/Valsartan | 131 | $173,488 |
| FarxigaDapagliflozin Propanediol | 26 | $29,322 |
| VascepaIcosapent Ethyl | 44 | $27,004 |
| Praluent PenAlirocumab | 20 | $23,644 |
| Repatha SureclickEvolocumab | 16 | $23,496 |
| BrilintaTicagrelor | 22 | $17,418 |
| JardianceEmpagliflozin | 22 | $14,791 |
| Icosapent Ethyl | 42 | $10,879 |
| Ezetimibe | 371 | $10,523 |
| Metoprolol Succinate | 605 | $8,885 |
| Valsartan | 274 | $8,058 |
| ClopidogrelClopidogrel Bisulfate | 615 | $7,961 |
| Atorvastatin Calcium | 689 | $7,878 |
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 | $380 | $295,665267 claims |
| Johnson & JohnsonXarelto | $628 | $248,554215 claims |
| NovartisEntresto | $172 | $173,488131 claims |
| AstraZenecaFarxiga, Brilinta, Crestor | $377 | $48,79261 claims |
| Boehringer IngelheimJardiance | $150 | $14,79122 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 80th percentile of 1,250 cardiovascular disease providers in Pennsylvania.
Other cardiovascular disease in Wyomissing
- Hemal GadaWormleysburg$1.8M
- Benjamin KalsmithPgh$1.7M
- Peter KoweyWynnewood$1.5M
- Paul ForfiaPhiladelphia$1.2M
- Quang BuiPhiladelphia$933K
- Rhian DaviesYork$853K
- Sarang MangalmurtiBryn Mawr$728K
- Sabahat BokhariAllentown$578K
- George GabrielPittsburgh$563K
- Rajesh DaveCamp Hill$442K
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.