Ruel Mariano, NP
Primary Care · Las Vegas, NVNPI 1114481785
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 100.0% of the total across 145 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 24 manufacturers, the largest accounting for just 22.5% — the pattern of someone who eats at a lot of different presentations. 2025 is the largest year on record at $1,248, 4.4 times the $286 reported in 2021. Among primary care clinicians in NV 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 145 payments — averaging $25.42 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Collegium Pharmaceutical, Inc.$830
- Salix Pharmaceuticals, A Division Of Bausch Health US, LLC$603
- AbbVie$522
- AstraZeneca$219
- E.r. Squibb & Sons, L.L.C.$172
- ITI, Inc. (d/b/a Intra-cellular Therapies, Inc.)$149
- plus $1K from 18 others
What the payments were for
- Food & beverage$3,686100%
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 |
|---|---|---|
| Collegium Pharmaceutical, Inc. | 45 | $830 |
| Salix Pharmaceuticals, A Division Of Bausch Health US, LLC | 30 | $603 |
| AbbVie | 19 | $522 |
| AstraZeneca | 2 | $219 |
| E.r. Squibb & Sons, L.L.C. | 6 | $172 |
| ITI, Inc. (d/b/a Intra-cellular Therapies, Inc.) | 1 | $149 |
| Indivior Inc. | 1 | $125 |
| Bayer | 1 | $122 |
| Novo Nordisk | 1 | $119 |
| Scilex Pharmaceuticals Inc. | 7 | $113 |
| Idorsia Pharmaceuticals US Inc | 1 | $112 |
| Forte Bio-pharma LLC | 5 | $105 |
| Amgen | 4 | $88 |
| Pfizer | 4 | $87 |
| Lundbeck LLC | 3 | $71 |
| Protega Pharmaceutials Inc | 3 | $57 |
| Astellas Pharma US Inc | 2 | $42 |
| Lilly USA, LLC | 3 | $40 |
| Biohaven Pharmaceutical Holding Company Ltd. | 2 | $33 |
| Mylan Specialty L.p. | 1 | $24 |
| Johnson & Johnson | 1 | $15 |
| Azurity Pharmaceuticals, Inc. | 1 | $13 |
| Redhill Biopharma Inc. | 1 | $12 |
| Eisai Inc. | 1 | $12 |
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
$3,686 in reported general payments places this provider in the 95th percentile of 81 primary care providers in Nevada.
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 |
|---|---|---|
| Oxycodone-AcetaminophenOxycodone Hcl/Acetaminophen | 530 | $136,134 |
| Xtampza ErOxycodone Myristate | 195 | $104,482 |
| RelistorMethylnaltrexone Bromide | 20 | $49,028 |
| Dupixent SyringeDupilumab | 12 | $46,108 |
| Nurtec OdtRimegepant Sulfate | 24 | $37,164 |
| Oxycodone Hcl | 1,135 | $28,677 |
| MovantikNaloxegol Oxalate | 71 | $26,076 |
| EliquisApixaban | 17 | $21,865 |
| OxycontinOxycodone Hcl | 18 | $21,597 |
| Hydrocodone-AcetaminophenHydrocodone/Acetaminophen | 445 | $14,797 |
| Morphine Sulfate ErMorphine Sulfate | 703 | $13,739 |
| Aimovig AutoinjectorErenumab-Aooe | 15 | $10,909 |
| LinzessLinaclotide | 16 | $9,510 |
| Lidocaine | 98 | $5,979 |
| Tizanidine Hcl | 699 | $5,007 |
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 |
|---|---|---|
| Collegium Pharmaceutical, Inc.Xtampza Er | $830 | $104,482195 claims |
| PfizerNurtec Odt, Eliquis | $87 | $59,02941 claims |
| Salix Pharmaceuticals, A Division Of Bausch Health US, LLCRelistor | $603 | $49,02820 claims |
| Redhill Biopharma Inc.Movantik | $12 | $26,07671 claims |
| AbbVieLinzess | $522 | $9,51016 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 81 primary care providers in Nevada.
Other primary care in Las Vegas
- Jennifer CribbLas Vegas$7K
- George Gabriel ToldnessLas Vegas$4K
- Jona SteadLas Vegas$3K
- Mario LuglioLas Vegas$3K
- Jocybel ItorralbaLas Vegas$3K
- Jerifaye FloresLas Vegas$2K
- Sneha ThomasLas Vegas$2K
- Yoslady MoralesLas Vegas$2K
- Christine EspenillaLas Vegas$2K
- Tina SajadiLas Vegas$2K
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.