Ricardo Cardona Guarache, MD
Clinical Cardiac Electrophysiology · Everett, WANPI 1962667485
Payments from drug & device makers
What this record shows
The money is spread across several categories — food and beverage (48.9%), travel and lodging and education — rather than concentrated in one kind of arrangement. Medtronic accounts for 61.6% of it on its own, with 6 other manufacturers making up the rest. Reporting peaked in 2019 at $2,599 and has fallen 74.8% since, to $655 in 2025. That places this record below the midpoint for clinical cardiac electrophysiology clinicians in WA, where the typical reported total is $7,912.
Across 48 payments — averaging $88.75 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Medtronic$3K
- Abbott$1K
- Boston Scientific$247
- Biosense Webster, Inc.$167
- Medical Device Business Services, Inc.$115
- Novo Nordisk$32
- plus $26 from 1 others
Across 27 payments — averaging $1059.91 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.
- Boston Scientific$29K
What the payments were for
- Travel & lodging$1,80642%
- Food & beverage$2,08449%
- Education$3709%
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 |
|---|---|---|
| Medtronic(2 entities) | 23 | $2,624 |
| Abbott | 12 | $1,048 |
| Boston Scientific | 5 | $247 |
| Biosense Webster, Inc. | 2 | $167 |
| Medical Device Business Services, Inc. | 4 | $115 |
| Novo Nordisk | 1 | $32 |
| Johnson & Johnson | 1 | $26 |
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.
- Micra$823
- Ensite Cardiac Mapping System$241
- AVEIR$230
- Cardiovascular- Research only$221
- Carto 3$140
How this compares
$4,260 in reported general payments places this provider in the 35th percentile of 68 clinical cardiac electrophysiology providers in Washington.
See all clinical cardiac electrophysiology providers in Washington →
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 |
|---|---|---|
| EliquisApixaban | 141 | $185,089 |
| XareltoRivaroxaban | 99 | $137,249 |
| JardianceEmpagliflozin | 44 | $49,223 |
| EntrestoSacubitril/Valsartan | 31 | $32,779 |
| MultaqDronedarone Hcl | 24 | $27,847 |
| Dabigatran EtexilateDabigatran Etexilate Mesylate | 25 | $8,494 |
| Flecainide Acetate | 154 | $6,129 |
| Metoprolol Succinate | 386 | $5,224 |
| SotalolSotalol Hcl | 145 | $3,255 |
| Digoxin | 71 | $2,350 |
| Atorvastatin Calcium | 148 | $2,191 |
| Propafenone Hcl | 28 | $2,187 |
| Losartan Potassium | 124 | $1,331 |
| Amiodarone Hcl | 76 | $1,232 |
| Amlodipine Besylate | 83 | $1,119 |
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 |
|---|---|---|
| Johnson & JohnsonXarelto | $26 | $137,24999 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 35th percentile of 68 clinical cardiac electrophysiology providers in Washington.
Other clinical cardiac electrophysiology in Everett
- Sandeep SharmaEverett$8K
- Sanjeev GarhwalEverett$498
- Gust BardySeattle$130.7M
- Babak NazerSeattle$124K
- Maheer GandhavadiBellevue$118K
- Toshimasa OkabeSeattle$114K
- Darryl WellsSeattle$112K
- Arun R Mahankali SridharSeattle$94K
- Jeanne PooleSeattle$81K
- Amier AhmadSunnyside$58K
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.