Ritsu Kuno, MD
Pulmonary Disease · Richmond, VANPI 1114950391
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 99.0% of the total across 463 separate payments, which is the pattern of a clinician who attends manufacturer presentations rather than one with a consulting arrangement. It is spread thinly across 38 manufacturers, the largest accounting for just 23.8% — the pattern of someone who eats at a lot of different presentations.
Across 463 payments — averaging $17.88 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- GSK$2K
- AstraZeneca$1K
- Sanofi$661
- Genentech USA, Inc.$652
- Boehringer Ingelheim$457
- Regeneron Healthcare Solutions, Inc.$333
- plus $3K from 32 others
Across 6 payments — averaging $9283.48 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.
- AstraZeneca$29K
- Merck$26K
What the payments were for
- Food & beverage$8,19799%
- Education$811%
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 |
|---|---|---|
| GSK | 136 | $1,967 |
| AstraZeneca | 63 | $1,410 |
| Sanofi | 34 | $661 |
| Genentech USA, Inc. | 50 | $652 |
| Boehringer Ingelheim | 21 | $457 |
| Regeneron Healthcare Solutions, Inc. | 19 | $333 |
| Amgen | 12 | $263 |
| Insmed, Inc. | 14 | $236 |
| Mylan Specialty L.p. | 14 | $210 |
| Grifols USA, LLC | 10 | $201 |
| Electromed, Inc. | 6 | $187 |
| Inogen, Inc. | 8 | $164 |
| Actelion Pharmaceuticals US, Inc. | 7 | $145 |
| Paratek Pharmaceuticals, Inc. | 8 | $141 |
| Vifor Pharma, Inc. | 7 | $127 |
| Novartis | 7 | $102 |
| Mallinckrodt Hospital Products Inc. | 4 | $94 |
| Philips North America LLC | 6 | $92 |
| Merck | 5 | $80 |
| Sanofi-aventis U.S. LLC | 1 | $79 |
| Pulmonx Corporation | 3 | $74 |
| Takeda Pharmaceuticals U.S.A., Inc. | 2 | $66 |
| United Therapeutics Corporation | 4 | $62 |
| ANI Pharmaceuticals, Inc. | 2 | $61 |
| Zealand Pharma US, Inc. | 3 | $59 |
| Intuitive Surgical | 1 | $44 |
| Sunovion Pharmaceuticals Inc. | 2 | $44 |
| Teva Pharmaceuticals USA, Inc. | 2 | $38 |
| Verona Pharma, Inc. | 2 | $34 |
| Atricure, Inc. | 1 | $34 |
| Pharming Healthcare, Inc. | 2 | $32 |
| Pfizer | 1 | $26 |
| Covis Pharma GmbH | 1 | $22 |
| Axsome Therapeutics, Inc. | 1 | $20 |
| Jazz Pharmaceuticals Inc. | 1 | $18 |
| Viatris Specialty LLC | 1 | $17 |
| Valeritas, Inc. | 1 | $13 |
| Bayer | 1 | $13 |
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.
How this compares
$8,278 in reported general payments places this provider in the 70th percentile of 317 pulmonary disease providers in Virginia.
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 |
|---|---|---|
| Trelegy ElliptaFluticasone/Umeclidin/Vilanter | 968 | $743,309 |
| OfevNintedanib Esylate | 24 | $316,280 |
| ArikayceAmikacin Liposomal/Neb.Accessr | 15 | $222,529 |
| Breztri AerosphereBudesonide/Glycopyr/Formoterol | 111 | $87,257 |
| Dupixent SyringeDupilumab | 14 | $52,327 |
| Breo ElliptaFluticasone/Vilanterol | 101 | $51,570 |
| Dupixent PenDupilumab | 11 | $46,450 |
| Stiolto RespimatTiotropium Br/Olodaterol Hcl | 66 | $44,615 |
| Anoro ElliptaUmeclidinium Brm/Vilanterol Tr | 90 | $43,934 |
| SymbicortBudesonide/Formoterol Fumarate | 126 | $39,382 |
| Spiriva RespimatTiotropium Bromide | 40 | $36,775 |
| EliquisApixaban | 27 | $21,437 |
| Albuterol Sulfate HfaAlbuterol Sulfate | 813 | $18,816 |
| Spiriva HandihalerTiotropium Bromide | 30 | $16,836 |
| DuleraMometasone/Formoterol | 29 | $15,999 |
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 |
|---|---|---|
| GSKTrelegy Ellipta, Breo Ellipta, Anoro Ellipta, Arnuity Ellipta | $1,967 | $851,7421,195 claims |
| Boehringer IngelheimOfev, Stiolto Respimat, Spiriva Respimat | $457 | $397,671130 claims |
| Insmed, Inc.Arikayce | $236 | $222,52915 claims |
| AstraZenecaBreztri Aerosphere, Symbicort | $1,410 | $126,639237 claims |
| PfizerEliquis | $26 | $21,43727 claims |
| MerckDulera | $80 | $15,99929 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 70th percentile of 317 pulmonary disease providers in Virginia.
Other pulmonary disease in Richmond
- Sujoy GillRichmond$296K
- Patricia SimeRichmond$113K
- Shilpa JohriRichmond$37K
- Apostolos PerelasRichmond$31K
- John SentzRichmond$20K
- Glenn GiesselRichmond$14K
- Nauman ChaudaryRichmond$13K
- Michael MistrettaRichmond$13K
- Steven NathanFalls Church$1.5M
- Omar MinaiHopewell$1.3M
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.