Juan Guarderas, MD
Allergy & Immunology · Valdosta, GANPI 1902893290
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 97.4% of the total across 188 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 Regeneron Healthcare Solutions, Inc. at 26.5% of the total. That places this record below the midpoint for allergy & immunology clinicians in GA, where the typical reported total is $4,504.
Across 188 payments — averaging $21.60 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Regeneron Healthcare Solutions, Inc.$1K
- GSK$1K
- CSL Behring$308
- AstraZeneca$269
- Sanofi$252
- Takeda Pharmaceuticals U.S.A., Inc.$190
- plus $908 from 18 others
What the payments were for
- Food & beverage$3,95297%
- Education$1083%
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 |
|---|---|---|
| Regeneron Healthcare Solutions, Inc. | 41 | $1,075 |
| GSK | 56 | $1,058 |
| CSL Behring | 14 | $308 |
| AstraZeneca | 15 | $269 |
| Sanofi | 10 | $252 |
| Takeda Pharmaceuticals U.S.A., Inc. | 8 | $190 |
| Grifols USA, LLC | 9 | $169 |
| Jazz Pharmaceuticals Inc. | 6 | $148 |
| Pfizer | 6 | $115 |
| ARS Pharmaceuticals Operations, Inc. | 3 | $81 |
| Pharming Healthcare, Inc. | 4 | $64 |
| Inspire Medical Systems, Inc. | 2 | $50 |
| Boehringer Ingelheim | 2 | $41 |
| Amgen | 1 | $34 |
| United Therapeutics Corporation | 2 | $30 |
| Biocryst US Sales Co., LLC | 1 | $30 |
| Harmony Biosciences LLC | 1 | $29 |
| Philips North America LLC | 1 | $23 |
| Aimmune Therapeutics, Inc. | 1 | $21 |
| Baxter Healthcare | 1 | $21 |
| Actelion Pharmaceuticals US, Inc. | 1 | $18 |
| Teva Pharmaceuticals USA, Inc. | 1 | $14 |
| Alk-abello, Inc | 1 | $13 |
| Inogen, Inc. | 1 | $8 |
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.
- DUPIXENT$234
How this compares
$4,060 in reported general payments places this provider in the 45th percentile of 107 allergy & immunology providers in Georgia.
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 |
|---|---|---|
| NucalaMepolizumab | 42 | $164,712 |
| Dupixent PenDupilumab | 12 | $42,194 |
| XolairOmalizumab | 15 | $40,050 |
| SymbicortBudesonide/Formoterol Fumarate | 44 | $13,641 |
| Budesonide-Formoterol FumarateBudesonide/Formoterol Fumarate | 16 | $2,358 |
| Albuterol Sulfate HfaAlbuterol Sulfate | 19 | $697 |
| Gabapentin | 38 | $558 |
| Fluticasone Propionate | 36 | $465 |
| Ipratropium Bromide | 12 | $333 |
| Amoxicillin-Clavulanate PotassAmoxicillin/Potassium Clav | 16 | $288 |
| Doxycycline Hyclate | 15 | $184 |
| Hydroxyzine Hcl | 15 | $163 |
| Azithromycin | 40 | $123 |
| Prednisone | 23 | $122 |
| Methylprednisolone | 21 | $121 |
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 |
|---|---|---|
| GSKNucala | $1,058 | $164,71242 claims |
| AstraZenecaSymbicort | $269 | $13,64144 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 45th percentile of 107 allergy & immunology providers in Georgia.
Other allergy & immunology in Valdosta
- Michael BlaissRoswell$1.1M
- Deborah BirxAtlanta$470K
- Tracy BridgesAlbany$364K
- Jack EadesMacon$237K
- Stanley FinemanMarietta$186K
- Robert CartwrightColumbus$169K
- Robert ChrzanowskiColumbus$115K
- Belinda GrahamSmyrna$94K
- Lily HwangRoswell$88K
- Paul RabinowitzAtlanta$57K
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.