Lany Avakian
Nurse Practitioner · Fresno, CANPI 1689849879
Payments from drug & device makers
Across 233 payments — averaging $18.61 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Daiichi Sankyo Inc.$796
- AstraZeneca$703
- Seagen Inc.$420
- Gilead$311
- Merck$300
- Eisai Inc.$253
- plus $2K from 26 others
What the payments were for
- Food & beverage$4,337100%
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 |
|---|---|---|
| Daiichi Sankyo Inc. | 77 | $796 |
| AstraZeneca | 29 | $703 |
| Seagen Inc. | 23 | $420 |
| Gilead | 7 | $311 |
| Merck | 16 | $300 |
| Eisai Inc. | 14 | $253 |
| GSK | 7 | $197 |
| Puma Biotechnology, Inc. | 8 | $141 |
| Pfizer | 7 | $131 |
| Pharmaessentia USA Corporation | 2 | $128 |
| Amgen | 6 | $125 |
| Heron Therapeutics, Inc. | 7 | $125 |
| Astellas Pharma Global Development | 1 | $97 |
| Boston Scientific | 5 | $82 |
| Tersera Therapeutics LLC | 2 | $68 |
| Lilly USA, LLC | 3 | $52 |
| Mylan Institutional Inc. | 2 | $46 |
| Mayne Pharma Commercial LLC | 2 | $44 |
| Novartis | 2 | $40 |
| EMD Serono, Inc. | 1 | $32 |
| Pharmacosmos Therapeutics Inc. | 1 | $26 |
| Stemline Therapeutics Inc. | 1 | $26 |
| Immunogen, Inc. | 1 | $26 |
| Genentech USA, Inc. | 1 | $23 |
| Dova Pharmaceuticals | 1 | $23 |
| Aadi Bioscience, Inc. | 1 | $22 |
| Boehringer Ingelheim | 1 | $20 |
| Bristol Myers Squibb | 1 | $19 |
| Clovis Oncology, Inc. | 1 | $18 |
| Karyopharm Therapeutics Inc. | 1 | $16 |
| Sobi, Inc | 1 | $14 |
| Foundation Medicine, Inc. | 1 | $13 |
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
$4,337 in reported general payments places this provider in the 90th percentile of 6,779 nurse practitioner providers in California.
Most prescribed under Part D
| Drug | Claims | Cost to plans & patients |
|---|---|---|
| Anastrozole | 11 | $193 |
Paid to pharmacies, not to this prescriber.
Other nurse practitioner in Fresno
- Erica BedstedFresno$194K
- Sonja GrowcottFresno$31K
- Rhonda HewittStanford$917K
- Linda TrinhIrvine$899K
- Denise SinagaNorthridge$728K
- Debbie TaySanta Monica$642K
- Joe GorelickCampbell$638K
- Lynsey LakinArcadia$540K
- Kelly ChoiRancho Cucamonga$483K
- Hamta ZareStanford$428K
Where these figures come from
- Payments: CMS Open Payments, program years 2019–2025 (publication P06302026_06032026).
- Identity: NPPES NPI Registry, July 2026.