Vijay Balasubramanian, MD
Pulmonary Disease · Fresno, CANPI 1548289093
Payments from drug & device makers
What this record shows
The money is spread across several categories — speaking fees (59.3%), consulting fees and travel and lodging — rather than concentrated in one kind of arrangement. 25 manufacturers reported payments, led by Boehringer Ingelheim at 33.1% of the total. 2025 is the largest year on record at $180,124, 4.2 times the $43,330 reported in 2019. Among pulmonary disease clinicians in CA 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 838 payments — averaging $631.72 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Boehringer Ingelheim$175K
- United Therapeutics Corporation$141K
- Actelion Pharmaceuticals US, Inc.$93K
- Merck$73K
- Bayer$37K
- Gilead$4K
- plus $6K from 19 others
Across 66 payments — averaging $3229.33 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.
- United Therapeutics Corporation$213K
What the payments were for
- Consulting fees$131,56125%
- Speaking & faculty fees$313,82059%
- Travel & lodging$59,32511%
- Food & beverage$24,3345%
- Education$3370%
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 |
|---|---|---|
| Boehringer Ingelheim | 184 | $175,197 |
| United Therapeutics Corporation | 265 | $140,778 |
| Actelion Pharmaceuticals US, Inc. | 170 | $92,619 |
| Merck | 87 | $73,342 |
| Bayer | 46 | $37,401 |
| Gilead | 9 | $4,266 |
| Chiesi USA, Inc. | 5 | $4,148 |
| AstraZeneca | 15 | $384 |
| GSK | 25 | $362 |
| Sandoz | 5 | $217 |
| Baxter Healthcare | 4 | $99 |
| Viatris Specialty LLC | 4 | $85 |
| Liquidia Technologies, Inc. | 1 | $81 |
| Philips North America LLC | 3 | $68 |
| Mylan Specialty L.p. | 2 | $58 |
| Insmed, Inc. | 2 | $51 |
| Verona Pharma, Inc. | 2 | $43 |
| Sanofi | 1 | $29 |
| Inari Medical, Inc. | 1 | $28 |
| Inspire Medical Systems, Inc. | 1 | $22 |
| Genentech USA, Inc. | 1 | $21 |
| Regeneron Healthcare Solutions, Inc. | 1 | $21 |
| ANI Pharmaceuticals, Inc. | 1 | $20 |
| Electromed, Inc. | 2 | $20 |
| Vifor Pharma, Inc. | 1 | $19 |
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
$529,378 in reported general payments places this provider in the 95th percentile of 1,261 pulmonary disease 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 |
|---|---|---|
| OfevNintedanib Esylate | 90 | $1,130,987 |
| Orenitram ErTreprostinil Diolamine | 48 | $1,012,816 |
| OpsumitMacitentan | 29 | $343,026 |
| AdempasRiociguat | 23 | $271,675 |
| LetairisAmbrisentan | 15 | $191,884 |
| Trelegy ElliptaFluticasone/Umeclidin/Vilanter | 101 | $78,095 |
| Tadalafil | 81 | $77,469 |
| Ambrisentan | 15 | $58,641 |
| Anoro ElliptaUmeclidinium Brm/Vilanterol Tr | 33 | $21,953 |
| Spiriva RespimatTiotropium Bromide | 31 | $17,857 |
| Breztri AerosphereBudesonide/Glycopyr/Formoterol | 22 | $15,749 |
| Breo ElliptaFluticasone/Vilanterol | 24 | $12,862 |
| Advair HfaFluticasone Propion/Salmeterol | 23 | $6,647 |
| Sildenafil Citrate | 22 | $4,353 |
| Albuterol Sulfate HfaAlbuterol Sulfate | 82 | $3,153 |
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 |
|---|---|---|
| Boehringer IngelheimOfev, Spiriva Respimat | $175,197 | $1,148,844121 claims |
| Actelion Pharmaceuticals US, Inc.Opsumit | $92,619 | $343,02629 claims |
| BayerAdempas | $37,401 | $271,67523 claims |
| GileadLetairis | $4,266 | $191,88415 claims |
| GSKTrelegy Ellipta, Anoro Ellipta, Breo Ellipta | $362 | $112,911158 claims |
| AstraZenecaBreztri Aerosphere | $384 | $15,74922 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 1,261 pulmonary disease providers in California.
Other pulmonary disease in Fresno
- Vijai DanielFresno$471K
- Samuel LouieSacramento$2.8M
- Shyamsunder SubramanianTracy$1.5M
- Toby MaherLos Angeles$1.3M
- Rajkumar DasguptaPasadena$930K
- Hoang leFountain Valley$814K
- Kevin FussellEncinitas$788K
- Revati ShreeniwasStanford$726K
- David PhamWestminster$571K
- Victor TapsonLos Angeles$514K
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.