Nelio Guzman Aguayo, MD
Nephrology · Spokane, WANPI 1124266184
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 98.6% of the total across 41 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 16 manufacturers, the largest accounting for just 22.9% — the pattern of someone who eats at a lot of different presentations.
Across 41 payments — averaging $28.98 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Akebia Therapeutics Inc$272
- Amgen$132
- Takeda Pharmaceuticals U.S.A., Inc.$125
- Vifor Pharma, Inc.$100
- Bayer$99
- GSK$96
- plus $365 from 10 others
What the payments were for
- Food & beverage$1,17299%
- Education$161%
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 |
|---|---|---|
| Akebia Therapeutics Inc | 2 | $272 |
| Amgen | 5 | $132 |
| Takeda Pharmaceuticals U.S.A., Inc. | 1 | $125 |
| Vifor Pharma, Inc. | 1 | $100 |
| Bayer | 6 | $99 |
| GSK | 5 | $96 |
| AstraZeneca(2 entities) | 2 | $85 |
| Novo Nordisk | 5 | $85 |
| Xeris Pharmaceuticals, Inc. | 2 | $42 |
| Boehringer Ingelheim | 2 | $37 |
| Scpharmaceuticals Inc. | 1 | $25 |
| Corcept Therapeutics | 1 | $21 |
| Lilly USA, LLC | 1 | $19 |
| Dexcom, Inc. | 1 | $17 |
| Calliditas Therapeutics US Inc. | 1 | $17 |
| Travere Therapeutics, Inc. | 5 | $16 |
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.
- AURYXIA$132
- LIVTENCITY$125
- Veltassa$100
How this compares
$1,188 in reported general payments places this provider in the 80th percentile of 237 nephrology 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 |
|---|---|---|
| JardianceEmpagliflozin | 144 | $197,050 |
| KerendiaFinerenone | 72 | $77,642 |
| FarxigaDapagliflozin Propanediol | 43 | $49,446 |
| OzempicSemaglutide | 13 | $27,086 |
| MounjaroTirzepatide | 17 | $22,913 |
| Calcitriol | 58 | $1,130 |
| Lisinopril | 132 | $1,116 |
| Doxazosin Mesylate | 45 | $737 |
| Amlodipine Besylate | 92 | $697 |
| Losartan Potassium | 67 | $662 |
| Potassium Chloride | 33 | $478 |
| Spironolactone | 50 | $326 |
| Metoprolol Succinate | 18 | $317 |
| Furosemide | 48 | $290 |
| Clonidine Hcl | 18 | $264 |
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 |
|---|---|---|
| Boehringer IngelheimJardiance | $37 | $197,050144 claims |
| BayerKerendia | $99 | $77,64272 claims |
| AstraZenecaFarxiga | $85 | $49,44643 claims |
| Novo NordiskOzempic | $85 | $27,08613 claims |
| Lilly USA, LLCMounjaro | $19 | $22,91317 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 80th percentile of 237 nephrology providers in Washington.
Other nephrology in Spokane
- Kathrine TuttleSpokane$421K
- Matthew RaySpokane$4K
- Saed NemrSpokane$4K
- Krishna MalireddiSpokane$3K
- Vijayakumar ReddySpokane$2K
- Nelson ChowSpokane$2K
- John MusaSpokane$1K
- Sean SanchezSpokane$1K
- Henry MrochSpokane$1K
- Satinder SinghSpokane$942
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.