Manuel Garmendia, PA
Physician Assistant · San Luis Obispo, CANPI 1437624103
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 93.5% of the total across 190 separate payments, which is the pattern of a clinician who attends manufacturer presentations rather than one with a consulting arrangement. It is spread thinly across 30 manufacturers, the largest accounting for just 19.2% — the pattern of someone who eats at a lot of different presentations. 2025 is the largest year on record at $1,106, 2.2 times the $514 reported in 2021. Among physician assistant 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 190 payments — averaging $22.38 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Astellas Pharma US Inc$817
- Sumitomo Pharma America, Inc.$580
- AbbVie$422
- Johnson & Johnson$368
- Pfizer$308
- Antares Pharma, Inc.$207
- plus $2K from 24 others
What the payments were for
- Food & beverage$3,97694%
- Education$2756%
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 |
|---|---|---|
| Astellas Pharma US Inc | 27 | $817 |
| Sumitomo Pharma America, Inc. | 29 | $580 |
| AbbVie | 23 | $422 |
| Johnson & Johnson | 19 | $368 |
| Pfizer | 14 | $308 |
| Antares Pharma, Inc. | 9 | $207 |
| Myriad Genetic Laboratories, Inc. | 4 | $177 |
| Urovant Sciences Inc | 10 | $144 |
| Blue Earth Diagnostics | 6 | $139 |
| Procept Biorobotics Corporation | 1 | $118 |
| Urogen Pharma, Inc. | 6 | $113 |
| Axonics, Inc. | 5 | $92 |
| Bayer | 4 | $87 |
| AstraZeneca | 5 | $86 |
| Bluewind Medical | 3 | $70 |
| Endo Pharmaceuticals Inc. | 3 | $59 |
| Merck | 3 | $56 |
| Amgen | 2 | $55 |
| Tolmar Pharmaceuticals, Inc. | 3 | $54 |
| Dendreon Pharmaceuticals LLC | 2 | $52 |
| Halozyme Inc | 2 | $49 |
| Verity Pharmaceuticals Inc. | 2 | $42 |
| Tolmar, Inc. | 1 | $29 |
| Progenics Pharmaceuticals, Inc. | 1 | $29 |
| Coloplast | 1 | $18 |
| Myovant Sciences Inc. | 1 | $18 |
| Kowa Pharmaceuticals America, Inc. | 1 | $16 |
| Ferring Pharmaceuticals Inc. | 1 | $15 |
| Boston Scientific | 1 | $15 |
| Sun Pharmaceutical Industries Inc. | 1 | $15 |
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.
- XTANDI$224
- AquaBeam Robotic System$118
- myRisk$113
How this compares
$4,251 in reported general payments places this provider in the 90th percentile of 10,423 physician assistant 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 |
|---|---|---|
| GemtesaVibegron | 359 | $394,993 |
| MyrbetriqMirabegron | 264 | $271,411 |
| Mirabegron ErMirabegron | 20 | $14,565 |
| Tamsulosin Hcl | 665 | $13,052 |
| Estradiol | 215 | $12,733 |
| Methenamine Hippurate | 122 | $12,384 |
| Solifenacin Succinate | 78 | $10,015 |
| PremarinEstrogens, Conjugated | 20 | $8,580 |
| XyostedTestosterone Enanthate | 12 | $7,502 |
| Finasteride | 374 | $5,006 |
| Tolterodine Tartrate ErTolterodine Tartrate | 26 | $3,507 |
| Nitrofurantoin Mono-MacroNitrofurantoin Monohyd/M-Cryst | 137 | $2,365 |
| Oxybutynin Chloride ErOxybutynin Chloride | 66 | $2,112 |
| Potassium Citrate ErPotassium Citrate | 20 | $1,839 |
| Alfuzosin Hcl ErAlfuzosin Hcl | 92 | $1,704 |
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 |
|---|---|---|
| Sumitomo Pharma America, Inc.Gemtesa | $580 | $394,993359 claims |
| Astellas Pharma US IncMyrbetriq | $817 | $271,411264 claims |
| PfizerPremarin | $308 | $8,58020 claims |
| Antares Pharma, Inc.Xyosted | $207 | $7,50212 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 10,423 physician assistant providers in California.
Other physician assistant in San Luis Obispo
- Andrea NguyenIrvine$1M
- Mikhail AlperMadera$889K
- Erin JensenUpland$716K
- Franklin ClineSacramento$458K
- Carla CrespoMarina del Rey$297K
- Katherine OsakiEl Centro$274K
- Shawna JonesFountain Valley$266K
- Heather AustinSalinas$219K
- Andrea FoxStanford$172K
- Asma HussainiThousand Oaks$102K
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.