Roy Akarakian, MD
Emergency Medicine · Los Angeles, CANPI 1295232338
Payments from drug & device makers
What this record shows
This record is dominated by education: $9,600 of the $11,671 with a category attached, or 82.3%. Pinnacle, Inc accounts for 82.3% of it on its own, with 10 other manufacturers making up the rest. Reporting peaked in 2022 at $4,941 and has fallen 90.8% since, to $457 in 2025. Among emergency medicine clinicians in CA with any reported payments, this total sits in the top 5% — high for the specialty, which is a reason to read the composition above rather than the number alone.
Across 26 payments — averaging $448.87 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Pinnacle, Inc$10K
- Pacira Pharmaceuticals Incorporated$790
- Arthrex$373
- Johnson & Johnson$257
- Stryker$203
- Bone Support Inc.$132
- plus $309 from 5 others
What the payments were for
- Travel & lodging$9758%
- Food & beverage$1,0969%
- Education$9,60082%
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 |
|---|---|---|
| Pinnacle, Inc | 9 | $9,607 |
| Pacira Pharmaceuticals Incorporated | 5 | $790 |
| Arthrex | 3 | $373 |
| Johnson & Johnson(2 entities) | 2 | $257 |
| Stryker | 1 | $203 |
| Bone Support Inc. | 1 | $132 |
| Vertex | 1 | $122 |
| Samsung HME America, Inc. | 1 | $100 |
| Bioventus LLC | 1 | $37 |
| Sonex Health, Inc. | 1 | $33 |
| Avanos Medical | 1 | $17 |
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.
- Iovera$754
- ALPHAVENT$203
- CEREPAK UNIFORM$149
- Embotrap$149
- CERAMENTBONE VOID FILLER$132
- CERAMENT G$132
- JOURNAVX$122
- XARELTO$108
- Hera W10$100
How this compares
$11,671 in reported general payments places this provider in the 95th percentile of 6,006 emergency medicine providers in California.
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 |
|---|---|---|
| Diclofenac Sodium | 37 | $867 |
| Naproxen | 18 | $115 |
| Ibuprofen | 18 | $91 |
| Hydrocodone-AcetaminophenHydrocodone/Acetaminophen | 14 | $47 |
| Ondansetron OdtOndansetron | 12 | $45 |
| Amoxicillin-Clavulanate PotassAmoxicillin/Potassium Clav | 11 | $40 |
| Sulfamethoxazole-TrimethoprimSulfamethoxazole/Trimethoprim | 12 | $40 |
Paid to pharmacies, not to this prescriber.
Other emergency medicine in Los Angeles
- Christopher PeabodyLos Angeles$163K
- Samuel BeckermanLos Angeles$81K
- Bharat KothakotaLos Angeles$51K
- Jay LeeLos Angeles$20K
- Anna Ryabets-LienhardLos Angeles$16K
- Michael BlueLone Pine$915K
- Andrew AccardiEncinitas$383K
- Fredrick Melik-AbrahamianSylmar$354K
- Graham WalkerStanford$309K
- Douglas WhiteOakland$220K
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.