Paramarajan Piranavan, MD
Rheumatology · Lexington, KYNPI 1295186799
Payments from drug & device makers
What this record shows
This record is dominated by consulting fees: $6,371 of the $8,316 with a category attached, or 76.6%. 6 manufacturers reported payments, led by AstraZeneca at 47.0% of the total. 2025 is the largest year on record at $5,329, more than ten times the $160 reported in 2019.
Across 23 payments — averaging $361.58 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- AstraZeneca$4K
- Amgen$3K
- Novartis$2K
- Cardinal Health 110 LLC$100
- Genentech USA, Inc.$100
- Biogen$41
Across 7 payments — averaging $39,299 each. Payments tied to a research study. These frequently flow through the physician to a hospital or research institution rather than to the physician personally.
- Amgen$248K
- Novartis$27K
What the payments were for
- Consulting fees$6,37177%
- Travel & lodging$94511%
- Food & beverage$89211%
- Education$1081%
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 |
|---|---|---|
| AstraZeneca | 8 | $3,906 |
| Amgen | 3 | $2,559 |
| Novartis | 8 | $1,610 |
| Cardinal Health 110 LLC | 1 | $100 |
| Genentech USA, Inc. | 1 | $100 |
| Biogen | 2 | $41 |
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
$8,316 in reported general payments places this provider in the 70th percentile of 81 rheumatology providers in Kentucky.
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 |
|---|---|---|
| Humira(Cf) PenAdalimumab | 112 | $1,092,092 |
| RinvoqUpadacitinib | 85 | $525,063 |
| Humira PenAdalimumab | 64 | $411,633 |
| Enbrel SureclickEtanercept | 47 | $351,723 |
| Cosentyx Sensoready (2 Pens)Secukinumab | 40 | $299,465 |
| Humira(Cf)Adalimumab | 36 | $269,981 |
| Orencia ClickjectAbatacept | 45 | $242,284 |
| HumiraAdalimumab | 25 | $237,547 |
| Bimzelx AutoinjectorBimekizumab-Bkzx | 12 | $176,868 |
| Actemra ActpenTocilizumab | 45 | $145,754 |
| Gamunex-CImmune Globul G/Gly/Iga Avg 46 | 12 | $107,994 |
| Taltz AutoinjectorIxekizumab | 11 | $100,207 |
| OtezlaApremilast | 20 | $95,907 |
| Enbrel MiniEtanercept | 13 | $85,886 |
| EnbrelEtanercept | 11 | $80,673 |
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 |
|---|---|---|
| AmgenOtezla, Enbrel | $2,559 | $176,58031 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 70th percentile of 81 rheumatology providers in Kentucky.
Other rheumatology in Lexington
- Alexander BrownLexington$10K
- Kelly ColeLexington$9K
- Elaine AlexanderLexington$8K
- Lucia HardiLexington$7K
- Izabela AnticLexington$5K
- Corey HatfieldLexington$4K
- Syed Haider AbbasLexington$3K
- Jeffrey NealLexington$3K
- Amna BatoolLexington$2K
- Robert LightfootLexington$2K
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.