Puvanalingam Ayyadurai, MD
Cardiovascular Disease · Grand Forks, NDNPI 1972919942
Payments from drug & device makers
What this record shows
The money is spread across several categories — food and beverage (53.9%), travel and lodging and education — rather than concentrated in one kind of arrangement. 14 manufacturers reported payments, led by Merck at 53.9% of the total. 2025 is the largest year on record at $1,571, 7.8 times the $201 reported in 2020. That places this record below the midpoint for cardiovascular disease clinicians in ND, where the typical reported total is $2,784.
Across 35 payments — averaging $82.85 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Merck$2K
- Heartflow, Inc.$371
- United Therapeutics Corporation$176
- Actelion Pharmaceuticals US, Inc.$146
- Abbott$130
- Astellas Pharma US Inc$100
- plus $416 from 8 others
Across 7 payments — averaging $19,093 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.
- Novartis$134K
What the payments were for
- Travel & lodging$1,17240%
- Food & beverage$1,56454%
- Education$1646%
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 |
|---|---|---|
| Merck | 9 | $1,562 |
| Heartflow, Inc. | 3 | $371 |
| United Therapeutics Corporation | 2 | $176 |
| Actelion Pharmaceuticals US, Inc. | 2 | $146 |
| Abbott | 2 | $130 |
| Astellas Pharma US Inc | 2 | $100 |
| AstraZeneca | 2 | $84 |
| ZOLL Services LLC (a/k/a ZOLL Lifecor Corp) | 6 | $83 |
| Edwards Lifesciences | 1 | $62 |
| Angiodynamics, Inc. | 1 | $60 |
| E.r. Squibb & Sons, L.L.C. | 1 | $50 |
| Novartis | 2 | $41 |
| Alnylam Pharmaceuticals Inc. | 1 | $21 |
| Lexicon Pharmaceuticals, Inc. | 1 | $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.
- FFRct$283
How this compares
$2,900 in reported general payments places this provider in the 50th percentile of 35 cardiovascular disease providers in North Dakota.
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 |
|---|---|---|
| VyndamaxTafamidis | 56 | $1,191,643 |
| Tyvaso DpiTreprostinil | 16 | $379,306 |
| OpsumitMacitentan | 38 | $369,183 |
| WinrevairSotatercept-Csrk | 11 | $298,364 |
| Orenitram ErTreprostinil Diolamine | 63 | $262,229 |
| Ambrisentan | 31 | $163,896 |
| JardianceEmpagliflozin | 152 | $123,379 |
| EntrestoSacubitril/Valsartan | 96 | $110,855 |
| EliquisApixaban | 86 | $79,658 |
| Repatha SureclickEvolocumab | 49 | $53,822 |
| XareltoRivaroxaban | 43 | $34,101 |
| Bumetanide | 358 | $9,224 |
| NexletolBempedoic Acid | 12 | $6,166 |
| Sildenafil Citrate | 46 | $4,694 |
| Isosorbide Mononitrate ErIsosorbide Mononitrate | 234 | $2,524 |
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 |
|---|---|---|
| Actelion Pharmaceuticals US, Inc.Opsumit | $146 | $369,18338 claims |
| MerckWinrevair | $1,562 | $298,36411 claims |
| NovartisEntresto | $41 | $110,85596 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 50th percentile of 35 cardiovascular disease providers in North Dakota.
Other cardiovascular disease in Grand Forks
- Noah ChelliahGrand Forks$115K
- Hussain BasrawalaGrand Forks$40K
- Mikhail KirnusGrand Forks$16K
- Rabeea AboufakherGrand Forks$14K
- Mohamed ChebacloGrand Forks$7K
- Abdelhamid AhmedGrand Forks$17
- Beng Loong Isaac TeaMinot$42K
- Thomas HaldisFargo$37K
- Matthew GlogozaFargo$36K
- Timothy PansegrauBismarck$16K
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.