Salvadeeswaran Lakshmi-Narayanan, MD
Pulmonary Disease · Espanola, NMNPI 1356470884
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 95.4% of the total across 34 separate payments, which is the pattern of a clinician who attends manufacturer presentations rather than one with a consulting arrangement. AstraZeneca accounts for 73.3% of it on its own, with 7 other manufacturers making up the rest. Reporting peaked in 2019 at $315 and has fallen 62.0% since, to $120 in 2025. That places this record below the midpoint for pulmonary disease clinicians in NM, where the typical reported total is $792.
Across 34 payments — averaging $23.53 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- AstraZeneca$586
- Mylan Specialty L.p.$53
- Circassia Inc.$48
- GSK$31
- Takeda Pharmaceuticals U.S.A., Inc.$27
- Boehringer Ingelheim$26
- plus $29 from 2 others
What the payments were for
- Food & beverage$76495%
- Education$375%
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 | 21 | $586 |
| Mylan Specialty L.p. | 3 | $53 |
| Circassia Inc. | 3 | $48 |
| GSK | 2 | $31 |
| Takeda Pharmaceuticals U.S.A., Inc. | 1 | $27 |
| Boehringer Ingelheim | 2 | $26 |
| Jazz Pharmaceuticals Inc. | 1 | $15 |
| Advanced Respiratory, Inc | 1 | $14 |
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.
- BREZTRI$223
How this compares
$800 in reported general payments places this provider in the 50th percentile of 56 pulmonary disease providers in New Mexico.
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 | 146 | $104,167 |
| Spiriva RespimatTiotropium Bromide | 134 | $91,097 |
| Breztri AerosphereBudesonide/Glycopyr/Formoterol | 83 | $74,006 |
| Stiolto RespimatTiotropium Br/Olodaterol Hcl | 86 | $52,249 |
| SymbicortBudesonide/Formoterol Fumarate | 66 | $19,785 |
| Arnuity ElliptaFluticasone Furoate | 71 | $18,368 |
| Advair HfaFluticasone Propion/Salmeterol | 46 | $18,217 |
| Spiriva HandihalerTiotropium Bromide | 27 | $16,663 |
| Bevespi AerosphereGlycopyrrolate/Formoterol Fum | 17 | $15,416 |
| Incruse ElliptaUmeclidinium Bromide | 35 | $15,357 |
| Breo ElliptaFluticasone/Vilanterol | 14 | $11,160 |
| Albuterol Sulfate HfaAlbuterol Sulfate | 302 | $9,342 |
| Ventolin HfaAlbuterol Sulfate | 98 | $6,682 |
| Qvar RedihalerBeclomethasone Dipropionate | 14 | $5,254 |
| Fluticasone Propionate HfaFluticasone Propionate | 15 | $4,231 |
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, Arnuity Ellipta, Incruse Ellipta, Breo Ellipta | $31 | $149,052266 claims |
| Boehringer IngelheimSpiriva Respimat, Stiolto Respimat | $26 | $143,346220 claims |
| AstraZenecaBreztri Aerosphere, Symbicort, Bevespi Aerosphere | $586 | $109,207166 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 50th percentile of 56 pulmonary disease providers in New Mexico.
Other pulmonary disease in Espanola
- Michael WagnerEspanola$664
- Lana Melendres GrovesAlbuquerque$1.1M
- Luke GabeSanta Fe$47K
- Michelle HarkinsAlbuquerque$24K
- Viral GandhiAlbuquerque$14K
- Gonzalo DiazAlamogordo$14K
- Arjan FloraAlbuquerque$10K
- Akshay SoodAlbuquerque$9K
- Alan OrellanaLas Cruces$5K
- Sivakumar NagarajuAlbuquerque$5K
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.