Sudhir Vyakaranam, MD
Nephrology · Mishawaka, INNPI 1407019037
Payments from drug & device makers
What this record shows
This record is dominated by speaking fees: $11,200 of the $17,872 with a category attached, or 62.7%. Mallinckrodt Enterprises LLC accounts for 71.0% of it on its own, with 25 other manufacturers making up the rest. Reporting peaked in 2019 at $12,899 and has fallen 95.4% since, to $599 in 2025. Among nephrology clinicians in IN with any reported payments, this total sits in the top 10% — high for the specialty, which is a reason to read the composition above rather than the number alone.
Across 170 payments — averaging $105.13 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Mallinckrodt Enterprises LLC$13K
- Mallinckrodt Hospital Products Inc.$2K
- Otsuka America Pharmaceutical, Inc.$443
- AstraZeneca$416
- Bayer$368
- Vifor Pharma, Inc.$296
- plus $2K from 20 others
Across 66 payments — averaging $3645.73 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.
- Vertex$124K
- CSL Behring$117K
What the payments were for
- Speaking & faculty fees$11,20063%
- Travel & lodging$2,91716%
- Food & beverage$3,48219%
- Education$2722%
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 |
|---|---|---|
| Mallinckrodt Enterprises LLC | 10 | $12,684 |
| Mallinckrodt Hospital Products Inc. | 10 | $2,024 |
| Otsuka America Pharmaceutical, Inc. | 17 | $443 |
| AstraZeneca(2 entities) | 23 | $416 |
| Bayer | 32 | $368 |
| Vifor Pharma, Inc. | 12 | $296 |
| Amgen | 13 | $210 |
| Nxstage Medical, Inc. | 3 | $181 |
| Aurinia Pharma U.S., Inc. | 4 | $172 |
| Travere Therapeutics, Inc. | 5 | $170 |
| Fresenius USA Marketing, Inc. | 7 | $161 |
| Novartis | 6 | $145 |
| GSK | 7 | $112 |
| Boehringer Ingelheim | 5 | $98 |
| Bard Peripheral Vascular, Inc. | 1 | $86 |
| OPKO Pharmaceuticals, LLC | 4 | $78 |
| Apellis Pharmaceuticals, Inc. | 1 | $29 |
| Lilly USA, LLC | 2 | $28 |
| Calliditas Therapeutics US Inc. | 1 | $25 |
| Scpharmaceuticals Inc. | 1 | $25 |
| Merck | 1 | $23 |
| Ardelyx, Inc. | 1 | $22 |
| Kyowa Kirin, Inc. | 1 | $22 |
| Akebia Therapeutics Inc | 1 | $21 |
| Novo Nordisk | 1 | $20 |
| Shire North American Group Inc | 1 | $15 |
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
$17,872 in reported general payments places this provider in the 90th percentile of 238 nephrology providers in Indiana.
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 |
|---|---|---|
| FarxigaDapagliflozin Propanediol | 204 | $141,011 |
| VelphoroSucroferric Oxyhydroxide | 31 | $106,964 |
| XphozahTenapanor Hcl | 11 | $49,673 |
| JardianceEmpagliflozin | 53 | $45,566 |
| KerendiaFinerenone | 50 | $41,617 |
| VeltassaPatiromer Calcium Sorbitex | 24 | $24,449 |
| LokelmaSodium Zirconium Cyclosilicate | 31 | $21,965 |
| RenvelaSevelamer Carbonate | 19 | $17,363 |
| EliquisApixaban | 16 | $14,639 |
| MyrbetriqMirabegron | 23 | $14,100 |
| Cinacalcet Hcl | 25 | $12,091 |
| VascepaIcosapent Ethyl | 17 | $8,356 |
| JanuviaSitagliptin Phosphate | 12 | $7,112 |
| Potassium Citrate ErPotassium Citrate | 32 | $6,907 |
| Potassium Chloride | 214 | $4,236 |
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 |
|---|---|---|
| AstraZenecaFarxiga, Lokelma | $416 | $162,976235 claims |
| Fresenius USA Marketing, Inc.Velphoro | $161 | $106,96431 claims |
| Boehringer IngelheimJardiance | $98 | $45,56653 claims |
| BayerKerendia | $368 | $41,61750 claims |
| MerckJanuvia | $23 | $7,11212 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 90th percentile of 238 nephrology providers in Indiana.
Other nephrology in Mishawaka
- Lily SunioMishawaka$4K
- Henry WuMishawaka$4K
- Swarupa EskapalliMishawaka$3K
- Rajiv AgarwalIndianapolis$1.2M
- Jay WishIndianapolis$502K
- Narothama Reddy AeddulaEvansville$125K
- Gaurav VermaTerre Haute$125K
- Manish GeraTerre Haute$113K
- Bruce MolitorisIndianapolis$108K
- Michael KrausIndianapolis$92K
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.