Ralph Laguardia, MD
Internal Medicine · Mansfield Center, CTNPI 1902805781
Payments from drug & device makers
Across 2,032 payments — averaging $16.23 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- AbbVie$8K
- AstraZeneca$2K
- Novo Nordisk$2K
- GSK$2K
- Pfizer$2K
- Salix Pharmaceuticals, A Division Of Bausch Health US, LLC$1K
- plus $16K from 54 others
What the payments were for
- Food & beverage$32,68899%
- Education$2941%
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.
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.
- TRELEGY ELLIPTA$347
- IBSRELA$130
- Wegovy$125
- AREXVY$103
How this compares
$32,982 in reported general payments places this provider in the 95th percentile of 2,067 internal medicine providers in Connecticut.
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 |
|---|---|---|
| OzempicSemaglutide | 312 | $337,615 |
| FarxigaDapagliflozin Propanediol | 155 | $224,492 |
| EliquisApixaban | 467 | $192,002 |
| KerendiaFinerenone | 113 | $172,699 |
| VraylarCariprazine Hcl | 95 | $152,036 |
| Trelegy ElliptaFluticasone/Umeclidin/Vilanter | 203 | $145,884 |
| XareltoRivaroxaban | 162 | $128,290 |
| JanuviaSitagliptin Phosphate | 95 | $127,603 |
| LinzessLinaclotide | 129 | $113,201 |
| JardianceEmpagliflozin | 106 | $94,348 |
| RybelsusSemaglutide | 45 | $85,393 |
| ZenpepLipase/Protease/Amylase | 13 | $66,029 |
| CreonLipase/Protease/Amylase | 14 | $51,542 |
| ProliaDenosumab | 25 | $42,986 |
| MyrbetriqMirabegron | 84 | $34,553 |
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 |
|---|---|---|
| Novo NordiskOzempic, Rybelsus | $2,316 | $423,008357 claims |
| AbbVieVraylar, Linzess, Creon | $7,712 | $316,779238 claims |
| AstraZenecaFarxiga, Airsupra | $2,359 | $248,755199 claims |
| PfizerEliquis | $1,579 | $192,002467 claims |
| BayerKerendia | $709 | $172,699113 claims |
| GSKTrelegy Ellipta, Breo Ellipta | $2,278 | $164,783241 claims |
| MerckJanuvia, Verquvo, Janumet Xr | $1,058 | $152,610149 claims |
| Johnson & JohnsonXarelto, Invokana | $668 | $147,267173 claims |
| Boehringer IngelheimJardiance, Tradjenta | $458 | $109,650125 claims |
| Takeda Pharmaceuticals U.S.A., Inc.Trintellix, Vyvanse, Adderall | $1,159 | $55,11775 claims |
| AmgenProlia | $302 | $42,98625 claims |
| Astellas Pharma US IncMyrbetriq | $764 | $34,55384 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 2,067 internal medicine providers in Connecticut.
Other internal medicine in Mansfield Center
- Joseph SouferWaterbury$21.5M
- David RadinStamford$7M
- Steven RyderWestport$3.9M
- Nancy BrownNew Haven$2.8M
- Charles MontanoCromwell$2.8M
- Arthur DecillisMadison$1M
- Michelle MallitzTrumbull$971K
- Allen HellerWoodbridge$758K
- Gary BlickNorwalk$717K
- Margaret ChusteckaHamden$652K
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.