Tigran Karamanukyan, MD
Vascular Surgery · Victorville, CANPI 1730561994
Payments from drug & device makers
What this record shows
The money is spread across several categories — food and beverage (46.6%), grants and travel and lodging — rather than concentrated in one kind of arrangement. 17 manufacturers reported payments, led by Medtronic at 47.1% of the total. 2025 is the largest year on record at $3,211, more than ten times the $203 reported in 2019.
Across 99 payments — averaging $115.44 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Medtronic$5K
- Shockwave Medical, Inc$1K
- Silk Road Medical, Inc.$1K
- Endologix LLC$950
- Smith+Nephew$928
- Bard Peripheral Vascular, Inc.$443
- plus $979 from 11 others
What the payments were for
- Grants$5,20346%
- Travel & lodging$8988%
- Food & beverage$5,32847%
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 |
|---|---|---|
| Medtronic(2 entities) | 8 | $5,379 |
| Shockwave Medical, Inc | 31 | $1,492 |
| Silk Road Medical, Inc. | 7 | $1,259 |
| Endologix LLC | 2 | $950 |
| Smith+Nephew | 16 | $928 |
| Bard Peripheral Vascular, Inc. | 17 | $443 |
| Kerecis Limited | 2 | $221 |
| Angiodynamics, Inc. | 1 | $200 |
| W. L. Gore & Associates, Inc. | 1 | $152 |
| Abbott | 2 | $141 |
| Organogenesis Inc. | 3 | $86 |
| Solventum Corporation | 4 | $69 |
| Boston Scientific | 1 | $29 |
| Cook Medical LLC | 1 | $26 |
| Philips North America LLC | 1 | $20 |
| Lemaitre Vascular, Inc. | 1 | $19 |
| Tactile Systems Technology Inc | 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.
- Endurant$5,203
- ENROUTE Transcarotid Neuroprotection System$1,088
- ENROUTE Transcarotid Stent$1,088
- Shockwave IVL System with the Shockwave C2 Coronary IVL Catheter$960
- ENDOCROSS Device$800
- Torus Stent Graft System$800
- Kerecis Omega3 SurgiClose$577
- GRAFIX PL$358
- Auryon Laser System 100-120 Vac$200
- Kerecis Omega3 GraftGuide$192
- Kerecis Omega3 Marigen$192
- LUTONIX$183
- GORE EXCLUDER AAA Endoprosthesis$152
- Alto Abdominal Stent Graft System$149
- ESPRIT$127
How this compares
$11,429 in reported general payments places this provider in the 70th percentile of 519 vascular surgery 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 |
|---|---|---|
| ClopidogrelClopidogrel Bisulfate | 24 | $226 |
| Gabapentin | 12 | $78 |
Paid to pharmacies, not to this prescriber.
Other vascular surgery in Victorville
- Armin FoghiVictorville$36K
- Son DuongFountain Valley$503K
- Venita ChandraPalo Alto$488K
- Sukgu HanLos Angeles$477K
- Leigh Ann ObanionFresno$469K
- Trevor DerderianRancho Mirage$359K
- Karthikeshwar KasirajanPalo Alto$349K
- Johnathon RolloLos Angeles$337K
- Melissa LojaFairfield$272K
- Jason LeePalo Alto$228K
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.