Lark Guss, MD
MOHS-Micrographic Surgery · Spokane, WANPI 1275973398
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 99.3% of the total across 56 separate payments, which is the pattern of a clinician who attends manufacturer presentations rather than one with a consulting arrangement. 18 manufacturers reported payments, led by AbbVie at 43.8% of the total. Reporting peaked in 2019 at $516 and has fallen 96.1% since, to $20 in 2025. That places this record below the midpoint for mohs-micrographic surgery clinicians in WA, where the typical reported total is $1,261.
Across 56 payments — averaging $18.88 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- AbbVie$463
- Lilly USA, LLC$98
- Novartis$69
- Pfizer$44
- Sanofi$44
- Arcutis Biotherapeutics, Inc.$41
- plus $298 from 12 others
What the payments were for
- Food & beverage$1,05099%
- Education$71%
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 |
|---|---|---|
| AbbVie(2 entities) | 24 | $463 |
| Lilly USA, LLC | 6 | $98 |
| Novartis | 4 | $69 |
| Pfizer | 3 | $44 |
| Sanofi | 2 | $44 |
| Arcutis Biotherapeutics, Inc. | 2 | $41 |
| Ortho Dermatologics, A Division Of Bausch Health US, LLC | 2 | $35 |
| Boehringer Ingelheim | 1 | $35 |
| Galderma Laboratories, L.p. | 2 | $35 |
| Dermavant Sciences, Inc. | 2 | $33 |
| Pierre Fabre Pharmaceuticals, Inc. | 1 | $30 |
| Sun Pharmaceutical Industries Inc. | 1 | $25 |
| Bristol Myers Squibb | 1 | $23 |
| Next Science LLC | 1 | $18 |
| Johnson & Johnson | 1 | $18 |
| UCB, Inc. | 1 | $17 |
| Helsinn Therapeutics (U.S.), Inc. | 1 | $17 |
| Regeneron Healthcare Solutions, Inc. | 1 | $11 |
How this compares
$1,057 in reported general payments places this provider in the 40th percentile of 38 mohs-micrographic surgery providers in Washington.
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 |
|---|---|---|
| Doxycycline Hyclate | 21 | $157 |
| Mupirocin | 13 | $111 |
Paid to pharmacies, not to this prescriber.
Other mohs-micrographic surgery in Spokane
- John NiaSpokane$5K
- Ein Gun SongMill Creek$4.5M
- Jeremy PeckRichland$9K
- Marcus TanRenton$8K
- Mikel MuseVancouver$6K
- Jennifer ReichelSeattle$5K
- Kirk EcklundYakima$5K
- Mustufa JafryMill Creek$4K
- Maureen MooneyUniversity Place$4K
- Nobuyoshi KageyamaRenton$4K
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.