Michael Picariello, MD
Otolaryngology/Facial Plastic Surgery · Exton, PANPI 1487642906
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 95.7% of the total across 155 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 34 manufacturers, the largest accounting for just 19.8% — the pattern of someone who eats at a lot of different presentations.
Across 155 payments — averaging $23.60 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Sanofi$723
- Regeneron Healthcare Solutions, Inc.$627
- GSK$408
- Acclarent, Inc$324
- Stryker$199
- Aerin Medical Inc.$174
- plus $1K from 28 others
What the payments were for
- Food & beverage$3,50396%
- Education$1564%
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 |
|---|---|---|
| Sanofi | 24 | $723 |
| Regeneron Healthcare Solutions, Inc. | 30 | $627 |
| GSK | 22 | $408 |
| Acclarent, Inc | 7 | $324 |
| Stryker | 5 | $199 |
| Aerin Medical Inc. | 6 | $174 |
| Harmony Biosciences LLC | 6 | $167 |
| Optinose US, Inc. | 8 | $143 |
| Novartis | 8 | $121 |
| Genentech USA, Inc. | 6 | $120 |
| Kaleo, Inc. | 4 | $67 |
| Intersect ENT, Inc. | 3 | $55 |
| Alk-abello, Inc | 2 | $44 |
| Phathom Pharmaceuticals, Inc. | 2 | $35 |
| Smith+Nephew | 1 | $34 |
| Axsome Therapeutics, Inc. | 1 | $33 |
| ARS Pharmaceuticals Operations, Inc. | 2 | $31 |
| Arbor Pharmaceuticals, Inc. | 2 | $30 |
| Pacira Pharmaceuticals Incorporated | 1 | $29 |
| Takeda Pharmaceuticals U.S.A., Inc. | 1 | $25 |
| Octapharma USA, Inc. | 1 | $24 |
| Jazz Pharmaceuticals Inc. | 1 | $23 |
| Integra Lifesciences Corporation | 1 | $23 |
| Medline Industries LP | 1 | $23 |
| Merck | 1 | $21 |
| Pfizer | 1 | $21 |
| Sanofi US Services Inc. | 1 | $20 |
| Resmed Corp | 1 | $20 |
| Inspire Medical Systems, Inc. | 1 | $20 |
| Lilly USA, LLC | 1 | $19 |
| Medtronic | 1 | $16 |
| Vertex | 1 | $15 |
| AstraZeneca | 1 | $13 |
| Cook Medical LLC | 1 | $11 |
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
$3,659 in reported general payments places this provider in the 65th percentile of 21 otolaryngology/facial plastic surgery providers in Pennsylvania.
See all otolaryngology/facial plastic surgery providers in Pennsylvania →
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 |
|---|---|---|
| Dupixent PenDupilumab | 13 | $49,478 |
| Fluticasone Propionate | 246 | $3,239 |
| Fluticasone-SalmeterolFluticasone Propion/Salmeterol | 11 | $2,532 |
| Ciprofloxacin-DexamethasoneCiprofloxacin Hcl/Dexameth | 21 | $2,287 |
| Ofloxacin | 33 | $588 |
| Clindamycin Hcl | 78 | $557 |
| Ipratropium Bromide | 16 | $549 |
| Omeprazole | 24 | $545 |
| Prednisone | 110 | $358 |
| Methylprednisolone | 54 | $312 |
| Levothyroxine Sodium | 17 | $288 |
| Amoxicillin-Clavulanate PotassAmoxicillin/Potassium Clav | 21 | $195 |
| Montelukast Sodium | 41 | $168 |
| Ciprofloxacin Hcl | 11 | $168 |
| Pantoprazole Sodium | 30 | $161 |
Paid to pharmacies, not to this prescriber.
Other otolaryngology/facial plastic surgery in Exton
- Adam MariottiExton$5K
- Jason BloomBryn Mawr$718K
- Donald SessoNorristown$23K
- Sean CarrollErie$6K
- Melissa SchwartzElkins Park$5K
- Jeffrey BrigliaLanghorne$4K
- Aykut UnsalPhiladelphia$4K
- Raphael GabayPhiladelphia$4K
- Jose UribeBethlehem$4K
- Harleen SethiPhiladelphia$3K
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.