Tulsi Sharma, MD
Endocrinology, Diabetes & Metabolism · Fresno, CANPI 1407180094
Payments from drug & device makers
Across 183 payments — averaging $16.35 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Novo Nordisk$479
- Lilly USA, LLC$343
- Amgen$287
- Abbott$242
- Radius Health, Inc.$199
- AstraZeneca$185
- plus $1K from 18 others
What the payments were for
- Food & beverage$2,83795%
- Education$953%
- Gifts$592%
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 |
|---|---|---|
| Novo Nordisk | 34 | $479 |
| Lilly USA, LLC | 26 | $343 |
| Amgen | 17 | $287 |
| Abbott | 10 | $242 |
| Radius Health, Inc. | 12 | $199 |
| AstraZeneca(2 entities) | 8 | $185 |
| Mannkind Corporation | 9 | $173 |
| Merck | 14 | $166 |
| AbbVie(2 entities) | 9 | $128 |
| Boehringer Ingelheim | 9 | $127 |
| Sanofi-aventis U.S. LLC | 11 | $121 |
| Neurocrine Biosciences, Inc. | 1 | $103 |
| Dexcom, Inc. | 1 | $98 |
| Ipsen Biopharmaceuticals, Inc | 3 | $50 |
| Bayer | 3 | $49 |
| Shire North American Group Inc | 3 | $41 |
| Insulet Corporation | 3 | $41 |
| Tandem Diabetes Care, Inc. | 2 | $38 |
| Medtronic | 2 | $38 |
| Kyowa Kirin, Inc. | 2 | $32 |
| Daiichi Sankyo Inc. | 1 | $14 |
| Xeris Pharmaceuticals, Inc. | 1 | $13 |
| Ultragenyx Pharmaceutical Inc. | 1 | $12 |
| Regeneron Healthcare Solutions, 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.
- CRENESSITY$103
How this compares
$2,991 in reported general payments places this provider in the 60th percentile of 952 endocrinology, diabetes & metabolism providers in California.
See all endocrinology, diabetes & metabolism 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 |
|---|---|---|
| OzempicSemaglutide | 198 | $231,852 |
| TrulicityDulaglutide | 128 | $162,426 |
| JardianceEmpagliflozin | 120 | $131,248 |
| MounjaroTirzepatide | 61 | $76,451 |
| JanuviaSitagliptin Phosphate | 56 | $60,503 |
| FarxigaDapagliflozin Propanediol | 52 | $47,289 |
| Tresiba Flextouch U-200Insulin Degludec | 51 | $42,760 |
| Basaglar Kwikpen U-100Insulin Glargine,hum.Rec.Anlog | 70 | $29,528 |
| Toujeo Max SolostarInsulin Glargine,hum.Rec.Anlog | 20 | $26,114 |
| Tresiba Flextouch U-100Insulin Degludec | 39 | $24,875 |
| Lantus SolostarInsulin Glargine,hum.Rec.Anlog | 151 | $19,384 |
| Humalog Kwikpen U-100Insulin Lispro | 65 | $18,996 |
| Insulin Lispro Kwikpen U-100Insulin Lispro | 60 | $18,403 |
| Fiasp FlextouchInsulin Aspart (Niacinamide) | 21 | $16,514 |
| Humulin R U-500 KwikpenInsulin Regular, Human | 13 | $14,169 |
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 |
|---|---|---|
| Lilly USA, LLCTrulicity, Mounjaro, Humalog | $343 | $243,132202 claims |
| Novo NordiskOzempic, Novolog | $479 | $236,187217 claims |
| Boehringer IngelheimJardiance | $127 | $131,248120 claims |
| MerckJanuvia | $166 | $60,50356 claims |
| AstraZenecaFarxiga | $185 | $47,28952 claims |
| AbbVieSynthroid | $128 | $1,14117 claims |
| Sanofi-aventis U.S. LLCLantus | $121 | $92014 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 60th percentile of 952 endocrinology, diabetes & metabolism providers in California.
Other endocrinology, diabetes & metabolism in Fresno
- Paul NorwoodFresno$6.2M
- Jerrold OlefskySan Diego$26.5M
- Mark ChristiansenWalnut Creek$22.9M
- Timothy BaileyEscondido$22.3M
- Stanley HsiaLos Angeles$19.8M
- Juan FriasSan Diego$14.1M
- Athena Philis-Tsimikasla Jolla$6M
- David AhnNewport Beach$5.8M
- Shlomo MelmedLos Angeles$3.3M
- Leila ChaychiSan Carlos$3.2M
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.