Heidi Nashed Guirguis, MD
Family Medicine · Spring, TXNPI 1609802818
Payments from drug & device makers
Across 269 payments — averaging $19.65 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Novo Nordisk$1K
- AstraZeneca$592
- Lilly USA, LLC$587
- Boehringer Ingelheim$554
- GSK$541
- Merck$219
- plus $1K from 21 others
What the payments were for
- Food & beverage$5,25899%
- Education$271%
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 |
|---|---|---|
| Novo Nordisk | 89 | $1,358 |
| AstraZeneca | 29 | $592 |
| Lilly USA, LLC | 29 | $587 |
| Boehringer Ingelheim | 27 | $554 |
| GSK | 20 | $541 |
| Merck | 14 | $219 |
| Amarin Pharma, Inc. | 6 | $193 |
| Salix Pharmaceuticals, A Division Of Bausch Health US, LLC | 6 | $180 |
| Amgen | 3 | $167 |
| Vertiflex, Inc. | 3 | $158 |
| Takeda Pharmaceuticals U.S.A., Inc. | 8 | $153 |
| Sanofi-aventis U.S. LLC | 7 | $100 |
| AbbVie(2 entities) | 5 | $79 |
| Pfizer | 4 | $70 |
| Shire North American Group Inc | 3 | $42 |
| Exact Sciences | 2 | $39 |
| Gilead | 2 | $39 |
| Arbor Pharmaceuticals, Inc. | 3 | $37 |
| Philips North America LLC | 1 | $28 |
| Inspire Medical Systems, Inc. | 1 | $25 |
| Azurity Pharmaceuticals, Inc. | 1 | $22 |
| Esperion Therapeutics, Inc. | 1 | $21 |
| Astellas Pharma US Inc | 1 | $21 |
| Eisai Inc. | 1 | $17 |
| Kowa Pharmaceuticals America, Inc. | 1 | $16 |
| Dexcom, Inc. | 1 | $14 |
| IBSA Pharma Inc. | 1 | $14 |
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
$5,285 in reported general payments places this provider in the 85th percentile of 8,760 family medicine providers in Texas.
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 |
|---|---|---|
| OzempicSemaglutide | 63 | $95,991 |
| MounjaroTirzepatide | 48 | $77,265 |
| Trelegy ElliptaFluticasone/Umeclidin/Vilanter | 49 | $42,341 |
| RybelsusSemaglutide | 17 | $29,410 |
| JardianceEmpagliflozin | 17 | $25,042 |
| EliquisApixaban | 15 | $22,972 |
| TrulicityDulaglutide | 13 | $20,116 |
| ProliaDenosumab | 11 | $18,153 |
| FarxigaDapagliflozin Propanediol | 17 | $10,468 |
| Tresiba Flextouch U-200Insulin Degludec | 12 | $9,565 |
| Rosuvastatin Calcium | 178 | $3,949 |
| Wixela InhubFluticasone Propion/Salmeterol | 33 | $3,842 |
| Lantus SolostarInsulin Glargine,hum.Rec.Anlog | 12 | $2,196 |
| SynthroidLevothyroxine Sodium | 21 | $2,076 |
| Levothyroxine Sodium | 227 | $2,037 |
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 |
|---|---|---|
| Novo NordiskOzempic, Rybelsus | $1,358 | $125,40180 claims |
| Lilly USA, LLCMounjaro, Trulicity | $587 | $97,38161 claims |
| GSKTrelegy Ellipta | $541 | $42,34149 claims |
| Boehringer IngelheimJardiance | $554 | $25,04217 claims |
| PfizerEliquis, Paxlovid | $70 | $24,40128 claims |
| AmgenProlia | $167 | $18,15311 claims |
| AstraZenecaFarxiga | $592 | $10,46817 claims |
| AbbVieSynthroid | $79 | $2,07621 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 85th percentile of 8,760 family medicine providers in Texas.
Other family medicine in Spring
- Mimi van der LedenSpring$2.6M
- Douglas DenhamSan Antonio$68.5M
- Vicki MillerPasadena$58.3M
- Hareshkumar BogharaDesoto$30.3M
- Earl MartinTomball$30.1M
- Lisa HollowayHouston$30.1M
- William SegerFort Worth$27.5M
- Veronica FragosoHouston$24.5M
- Joel SolisMcAllen$21.1M
- George AtieeSan Antonio$19.9M
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.