Ignacio Guzman, MD
Family Medicine · Fresno, CANPI 1770895724
Payments from drug & device makers
Across 266 payments — averaging $16.93 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- AstraZeneca$696
- Lilly USA, LLC$587
- Novo Nordisk$553
- AbbVie$526
- Johnson & Johnson$490
- Amarin Pharma, Inc.$439
- plus $1K from 21 others
What the payments were for
- Food & beverage$4,491100%
- Education$120%
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 | 30 | $696 |
| Lilly USA, LLC | 35 | $587 |
| Novo Nordisk | 48 | $553 |
| AbbVie(2 entities) | 32 | $526 |
| Johnson & Johnson(2 entities) | 17 | $490 |
| Amarin Pharma, Inc. | 39 | $439 |
| Novartis | 12 | $210 |
| GSK | 9 | $140 |
| Madrigal Pharmaceuticals | 1 | $124 |
| Boehringer Ingelheim | 6 | $113 |
| Merck | 7 | $105 |
| Sanofi-aventis U.S. LLC | 6 | $101 |
| Bayer | 4 | $84 |
| Amgen(2 entities) | 4 | $69 |
| Pfizer | 3 | $42 |
| Ironwood Pharmaceuticals, Inc | 2 | $37 |
| Tosoh Bioscience, Inc. | 1 | $24 |
| Gilead | 1 | $22 |
| Dexcom, Inc. | 1 | $18 |
| E.r. Squibb & Sons, L.L.C. | 1 | $17 |
| Vertiflex, Inc. | 1 | $16 |
| Redhill Biopharma Inc. | 1 | $16 |
| Idorsia Pharmaceuticals US Inc | 1 | $16 |
| Nestle Healthcare Nutrition Inc. | 1 | $16 |
| Salix Pharmaceuticals, A Division Of Bausch Health US, LLC | 1 | $15 |
| Arbor Pharmaceuticals, Inc. | 1 | $12 |
| Galderma Laboratories, L.p. | 1 | $12 |
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
$4,502 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 |
|---|---|---|
| TrulicityDulaglutide | 120 | $216,406 |
| OzempicSemaglutide | 94 | $129,409 |
| JardianceEmpagliflozin | 89 | $124,113 |
| TradjentaLinagliptin | 96 | $117,422 |
| FarxigaDapagliflozin Propanediol | 90 | $99,710 |
| XareltoRivaroxaban | 49 | $73,922 |
| VascepaIcosapent Ethyl | 96 | $66,047 |
| KerendiaFinerenone | 42 | $61,673 |
| Soliqua 100-33Insulin Glargine/Lixisenatide | 52 | $47,762 |
| JanuviaSitagliptin Phosphate | 31 | $39,155 |
| EliquisApixaban | 30 | $37,732 |
| Janumet XrSitagliptin Phos/Metformin Hcl | 28 | $37,391 |
| LinzessLinaclotide | 21 | $25,992 |
| EntrestoSacubitril/Valsartan | 14 | $25,007 |
| Icosapent Ethyl | 84 | $23,293 |
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, Glyxambi, Combivent Respimat | $113 | $272,295213 claims |
| Lilly USA, LLCTrulicity | $587 | $216,406120 claims |
| Novo NordiskOzempic | $553 | $129,40994 claims |
| AstraZenecaFarxiga | $696 | $99,71090 claims |
| Johnson & JohnsonXarelto, Invokana | $490 | $93,16561 claims |
| MerckJanuvia, Janumet Xr | $105 | $76,54659 claims |
| BayerKerendia | $84 | $61,67342 claims |
| Sanofi-aventis U.S. LLCSoliqua 100-33 | $101 | $47,76252 claims |
| PfizerEliquis | $42 | $37,73230 claims |
| AbbVieLinzess, Synthroid | $526 | $27,63233 claims |
| NovartisEntresto | $210 | $25,00714 claims |
| GSKTrelegy Ellipta | $140 | $12,44614 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.