Ravinder Agarwal, MD
Allergy & Immunology · West Des Moines, IANPI 1477538007
Payments from drug & device makers
What this record shows
This record is dominated by food and beverage: $1,675 of the $1,893 with a category attached, or 88.5%. 20 manufacturers reported payments, led by AstraZeneca at 26.3% of the total.
Across 101 payments — averaging $18.74 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- AstraZeneca$497
- GSK$252
- Takeda Pharmaceuticals U.S.A., Inc.$217
- Sanofi-aventis U.S. LLC$157
- Novartis$115
- Sanofi$101
- plus $554 from 14 others
What the payments were for
- Food & beverage$1,67588%
- Education$21812%
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 |
|---|---|---|
| AstraZeneca | 23 | $497 |
| GSK | 26 | $252 |
| Takeda Pharmaceuticals U.S.A., Inc. | 11 | $217 |
| Sanofi-aventis U.S. LLC | 2 | $157 |
| Novartis | 6 | $115 |
| Sanofi | 5 | $101 |
| CSL Behring | 4 | $85 |
| Pharming Healthcare, Inc. | 4 | $84 |
| Biocryst US Sales Co., LLC | 4 | $73 |
| Insmed, Inc. | 3 | $68 |
| Teva Pharmaceuticals USA, Inc. | 2 | $36 |
| Alk-abello, Inc | 2 | $32 |
| Genentech USA, Inc. | 1 | $29 |
| Regeneron Healthcare Solutions, Inc. | 1 | $29 |
| Bio Products Laboratory USA, Inc. | 2 | $24 |
| Aimmune Therapeutics, Inc. | 1 | $23 |
| Amgen | 1 | $22 |
| ARS Pharmaceuticals Operations, Inc. | 1 | $17 |
| Greer Laboratories, Inc. | 1 | $16 |
| Pfizer | 1 | $16 |
How this compares
$1,893 in reported general payments places this provider in the 65th percentile of 32 allergy & immunology providers in Iowa.
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 |
|---|---|---|
| HizentraImmun Glob G(Igg)/Pro/Iga 0-50 | 11 | $77,369 |
| Spiriva RespimatTiotropium Bromide | 18 | $15,672 |
| Breo ElliptaFluticasone/Vilanterol | 31 | $12,100 |
| Arnuity ElliptaFluticasone Furoate | 44 | $11,289 |
| Trelegy ElliptaFluticasone/Umeclidin/Vilanter | 14 | $9,288 |
| DuleraMometasone/Formoterol | 21 | $7,441 |
| Fluticasone-SalmeterolFluticasone Propion/Salmeterol | 18 | $3,417 |
| SymbicortBudesonide/Formoterol Fumarate | 11 | $3,023 |
| Ipratropium Bromide | 73 | $1,835 |
| Albuterol Sulfate HfaAlbuterol Sulfate | 25 | $526 |
| Fluticasone Propionate | 28 | $467 |
| Hydroxyzine Hcl | 23 | $377 |
| Amoxicillin-Clavulanate PotassAmoxicillin/Potassium Clav | 26 | $271 |
| Triamcinolone Acetonide | 28 | $227 |
| Montelukast Sodium | 41 | $215 |
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 |
|---|---|---|
| CSL BehringHizentra | $85 | $77,36911 claims |
| GSKBreo Ellipta, Arnuity Ellipta, Trelegy Ellipta | $252 | $32,67789 claims |
| AstraZenecaSymbicort | $497 | $3,02311 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 65th percentile of 32 allergy & immunology providers in Iowa.
Other allergy & immunology in West Des Moines
- Vuong NayimaWest Des Moines$34K
- Fadi AlkhatibWest Des Moines$16K
- Ahmad AlshashWest Des Moines$872
- Jennifer PettsWest Des Moines$163
- Daniel HamilosMason City$11K
- Lyla SchweigerCedar Rapids$6K
- Edward NassifAmes$5K
- Holly BrownCedar Rapids$4K
- Whitney MolisDes Moines$4K
- Safia NawazDes Moines$4K
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.