Paul Manoukian
Otolaryngology · Carson City, NVNPI 1083673909
Payments from drug & device makers
What this record shows
This record is dominated by consulting fees: $4,800 of the $6,755 with a category attached, or 71.1%. Medical Device Business Services, Inc. accounts for 65.6% of it on its own, with 14 other manufacturers making up the rest. Reporting peaked in 2023 at $5,016 and has fallen 87.4% since, to $631 in 2025.
Across 49 payments — averaging $137.85 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Medical Device Business Services, Inc.$4K
- Acclarent, Inc$887
- Regeneron Healthcare Solutions, Inc.$372
- Aerin Medical Inc.$352
- Medtronic$189
- Regeneron$107
- plus $417 from 9 others
What the payments were for
- Consulting fees$4,80071%
- Food & beverage$1,86628%
- Education$891%
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 |
|---|---|---|
| Medical Device Business Services, Inc. | 5 | $4,431 |
| Acclarent, Inc | 6 | $887 |
| Regeneron Healthcare Solutions, Inc. | 18 | $372 |
| Aerin Medical Inc. | 3 | $352 |
| Medtronic(2 entities) | 3 | $189 |
| Regeneron | 1 | $107 |
| Sanofi-aventis U.S. LLC | 1 | $89 |
| Ascendis Pharma Endocrinology Inc | 1 | $77 |
| GSK | 3 | $66 |
| Sanofi | 2 | $50 |
| Amgen | 2 | $42 |
| Optinose US, Inc. | 1 | $29 |
| Stryker | 1 | $25 |
| Pfizer | 1 | $25 |
| Inspire Medical Systems, Inc. | 1 | $14 |
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.
- TruDi Nav Cable$380
- VIVAER STYLUS$325
- RHINAER STYLUS$325
- NUVENT$141
- DUPIXENT$107
How this compares
$6,755 in reported general payments places this provider in the 85th percentile of 41 otolaryngology providers in Nevada.
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 |
|---|---|---|
| Ipratropium Bromide | 155 | $7,708 |
| Fluticasone Propionate | 226 | $3,583 |
| Montelukast Sodium | 52 | $856 |
| Omeprazole | 62 | $650 |
| Ofloxacin | 15 | $556 |
| Azelastine Hcl | 18 | $490 |
| Hydrocodone-AcetaminophenHydrocodone/Acetaminophen | 50 | $458 |
| Amoxicillin-Clavulanate PotassAmoxicillin/Potassium Clav | 28 | $311 |
| Clindamycin Hcl | 16 | $200 |
| Triamterene-HydrochlorothiazidTriamterene/Hydrochlorothiazid | 13 | $118 |
| Amoxicillin | 11 | $53 |
| Levothyroxine Sodium | 16 | $41 |
Paid to pharmacies, not to this prescriber.
Other otolaryngology in Carson City
- Philip SchlagerCarson City$435
- Ashley SikandHenderson$284K
- Oluwafunmilola OkuyemiLas Vegas$60K
- Jeannie KhavkinLas Vegas$22K
- Lakeisha HenryHenderson$9K
- Robert WangLas Vegas$9K
- Suparna ShahLas Vegas$8K
- Randall WeingartenHenderson$5K
- Candice YipLas Vegas$5K
- Daniel HiltonLas Vegas$5K
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.