Nirmal Guragai, MD
Cardiology · Fayetteville, NCNPI 1356837165
Payments from drug & device makers
What this record shows
This record is dominated by food and beverage: $2,656 of the $4,011 with a category attached, or 66.2%. 21 manufacturers reported payments, led by Medtronic at 57.4% of the total. Reporting peaked in 2022 at $2,738 and has fallen 83.1% since, to $464 in 2025. Among cardiology clinicians in NC with any reported payments, this total sits in the top 5% — high for the specialty, which is a reason to read the composition above rather than the number alone.
Across 88 payments — averaging $45.58 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Medtronic$2K
- Edwards Lifesciences$373
- Boehringer Ingelheim$240
- Pfizer$194
- Abiomed$172
- E.r. Squibb & Sons, L.L.C.$146
- plus $584 from 15 others
What the payments were for
- Travel & lodging$1,35434%
- Food & beverage$2,65666%
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 |
|---|---|---|
| Medtronic | 22 | $2,302 |
| Edwards Lifesciences | 6 | $373 |
| Boehringer Ingelheim | 7 | $240 |
| Pfizer | 11 | $194 |
| Abiomed | 3 | $172 |
| E.r. Squibb & Sons, L.L.C. | 9 | $146 |
| Amgen | 7 | $121 |
| Novo Nordisk | 3 | $75 |
| Philips North America LLC | 3 | $75 |
| Novartis | 4 | $70 |
| Cardiovascular Systems Inc. | 2 | $31 |
| AstraZeneca | 2 | $28 |
| Siemens Medical Solutions USA, Inc. | 1 | $26 |
| Shockwave Medical, Inc | 1 | $24 |
| Bayer | 1 | $22 |
| Johnson & Johnson | 1 | $21 |
| Cardiva Medical, Inc. | 1 | $20 |
| Agepha Pharma FZ LLC | 1 | $20 |
| Merck | 1 | $18 |
| Bridgebio Pharma, Inc. | 1 | $17 |
| Vital Connect, Inc | 1 | $17 |
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.
- COREVALVE EVOLUT R$712
- RESOLUTE ONYX$598
- JARDIANCE$111
- Impella$106
How this compares
$4,011 in reported general payments places this provider in the 95th percentile of 25 cardiology providers in North Carolina.
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 |
|---|---|---|
| EliquisApixaban | 158 | $155,494 |
| FarxigaDapagliflozin Propanediol | 27 | $31,775 |
| EntrestoSacubitril/Valsartan | 37 | $31,205 |
| XareltoRivaroxaban | 27 | $29,067 |
| BrilintaTicagrelor | 26 | $19,360 |
| JardianceEmpagliflozin | 13 | $12,572 |
| Atorvastatin Calcium | 140 | $1,588 |
| Metoprolol Succinate | 132 | $1,127 |
| ClopidogrelClopidogrel Bisulfate | 82 | $693 |
| Carvedilol | 105 | $656 |
| Rosuvastatin Calcium | 55 | $558 |
| Amiodarone Hcl | 55 | $519 |
| Losartan Potassium | 64 | $395 |
| Nifedipine ErNifedipine | 22 | $371 |
| Torsemide | 24 | $370 |
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 |
|---|---|---|
| PfizerEliquis | $194 | $155,494158 claims |
| AstraZenecaFarxiga, Brilinta | $28 | $51,13553 claims |
| NovartisEntresto | $70 | $31,20537 claims |
| Johnson & JohnsonXarelto | $21 | $29,06727 claims |
| Boehringer IngelheimJardiance | $240 | $12,57213 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 95th percentile of 25 cardiology providers in North Carolina.
Other cardiology in Fayetteville
- Cara HokeDurham$482
- Lakshmi NarasimhanJacksonville$433
- Karen Flores RosarioMorrisville$84
- Chandroth PurushothamanMorehead City$70
- James McGovernAsheville$0
- Anna Lisa ChamisDurham$0
- Monique StarksDurham$0
- Richard StaceyWinston Salem$0
- Juliette LoganRaleigh$0
- Frederic KahlWinston Salem$0
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.