Joan Nunoo
Primary Care · Fresno, CANPI 1700407426
Payments from drug & device makers
What this record shows
This record is dominated by food and beverage: $2,642 of the $3,627 with a category attached, or 72.8%. 18 manufacturers reported payments, led by Medtronic at 33.3% of the total. 2025 is the largest year on record at $1,543, more than ten times the $62 reported in 2021. Among primary care clinicians in CA with any reported payments, this total sits in the top 10% — high for the specialty, which is a reason to read the composition above rather than the number alone.
Across 96 payments — averaging $37.78 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Medtronic$1K
- Salix Pharmaceuticals, A Division Of Bausch Health US, LLC$688
- Nevro Corp.$415
- Globus Medical$298
- Biotronik NRO, Inc.$229
- Novo Nordisk$125
- plus $665 from 12 others
What the payments were for
- Travel & lodging$94026%
- Food & beverage$2,64273%
- Education$451%
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 |
|---|---|---|
| Medtronic | 18 | $1,207 |
| Salix Pharmaceuticals, A Division Of Bausch Health US, LLC | 36 | $688 |
| Nevro Corp. | 13 | $415 |
| Globus Medical | 10 | $298 |
| Biotronik NRO, Inc. | 3 | $229 |
| Novo Nordisk | 1 | $125 |
| Eisai Inc. | 1 | $125 |
| Edwards Lifesciences | 1 | $125 |
| Neurocrine Biosciences, Inc. | 1 | $75 |
| Acadia Pharmaceuticals Inc | 1 | $62 |
| Amneal Pharmaceuticals LLC | 3 | $56 |
| Otsuka America Pharmaceutical, Inc. | 1 | $50 |
| Vertex | 2 | $46 |
| Nalu Medical, Inc. | 1 | $39 |
| Metacel Pharmaceuticals LLC | 1 | $25 |
| Scilex Pharmaceuticals Inc. | 1 | $24 |
| MML US, Inc. | 1 | $21 |
| SPR Therapeutics, Inc | 1 | $17 |
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
$3,627 in reported general payments places this provider in the 90th percentile of 706 primary care 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 |
|---|---|---|
| RelistorMethylnaltrexone Bromide | 22 | $51,985 |
| ZtlidoLidocaine | 60 | $22,683 |
| Lidocaine | 156 | $13,839 |
| Celecoxib | 121 | $10,088 |
| Hydrocodone-AcetaminophenHydrocodone/Acetaminophen | 240 | $5,228 |
| Buprenorphine | 22 | $4,766 |
| Pregabalin | 173 | $3,642 |
| Gabapentin | 249 | $3,286 |
| Diclofenac Sodium | 64 | $2,546 |
| Baclofen | 123 | $1,840 |
| Tramadol Hcl | 128 | $1,684 |
| Duloxetine Hcl | 69 | $1,526 |
| Cyclobenzaprine Hcl | 174 | $1,500 |
| Acetaminophen-CodeineAcetaminophen With Codeine | 42 | $1,393 |
| Naloxone Hcl | 19 | $1,082 |
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 |
|---|---|---|
| Salix Pharmaceuticals, A Division Of Bausch Health US, LLCRelistor | $688 | $51,98522 claims |
| Scilex Pharmaceuticals Inc.Ztlido | $24 | $22,68360 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 706 primary care providers in California.
Other primary care in Fresno
- Brittney StanleyFresno$14K
- Sherri NashFresno$9K
- Phaxi YangFresno$8K
- Michelle BergenFresno$4K
- Melissa ManriquesFresno$4K
- Leslie FletcherTorrance$1.8M
- Hamideh PourzandLos Angeles$103K
- Veronica RamirezSacramento$83K
- Tyson FieldstedBakersfield$65K
- Kathryn CooperSan Diego$31K
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.