Vivian Nanagas, MD
Allergy & Immunology · Zionsville, INNPI 1285977033
Payments from drug & device makers
What this record shows
This record is dominated by food and beverage: $231 of the $288 with a category attached, or 80.3%. It is spread thinly across 8 manufacturers, the largest accounting for just 21.4% — the pattern of someone who eats at a lot of different presentations. That places this record below the midpoint for allergy & immunology clinicians in IN, where the typical reported total is $4,393.
Across 15 payments — averaging $19.18 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- AstraZeneca$61
- Welch Allyn$57
- GSK$48
- Pfizer$36
- Sanofi$28
- Amgen$26
- plus $30 from 2 others
What the payments were for
- Food & beverage$23180%
- Other$5720%
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 | 4 | $61 |
| Welch Allyn | 1 | $57 |
| GSK | 3 | $48 |
| Pfizer | 2 | $36 |
| Sanofi | 2 | $28 |
| Amgen | 1 | $26 |
| Takeda Pharmaceuticals U.S.A., Inc. | 1 | $19 |
| Regeneron Healthcare Solutions, Inc. | 1 | $11 |
How this compares
$288 in reported general payments places this provider in the 10th percentile of 49 allergy & immunology 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 |
|---|---|---|
| Dupixent PenDupilumab | 21 | $80,285 |
| Trelegy ElliptaFluticasone/Umeclidin/Vilanter | 62 | $54,352 |
| Breo ElliptaFluticasone/Vilanterol | 55 | $27,013 |
| Spiriva RespimatTiotropium Bromide | 31 | $20,414 |
| Epinephrine | 50 | $8,260 |
| Incruse ElliptaUmeclidinium Bromide | 22 | $8,241 |
| SymbicortBudesonide/Formoterol Fumarate | 20 | $7,488 |
| Budesonide-Formoterol FumarateBudesonide/Formoterol Fumarate | 57 | $7,181 |
| Fluticasone-SalmeterolFluticasone Propion/Salmeterol | 47 | $6,129 |
| Azelastine Hcl | 120 | $3,509 |
| Wixela InhubFluticasone Propion/Salmeterol | 19 | $2,648 |
| Albuterol Sulfate HfaAlbuterol Sulfate | 65 | $1,709 |
| Fluticasone Propionate | 118 | $1,589 |
| Montelukast Sodium | 158 | $1,300 |
| Levalbuterol Tartrate HfaLevalbuterol Tartrate | 19 | $1,120 |
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, Breo Ellipta, Incruse Ellipta | $48 | $89,607139 claims |
| AstraZenecaSymbicort | $61 | $7,48820 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 10th percentile of 49 allergy & immunology providers in Indiana.
Other allergy & immunology in Zionsville
- Anita SivamZionsville$9K
- Ann EsquivelZionsville$8K
- Nabeel FarooquiFishers$1.2M
- David PattersonNoblesville$252K
- William SmitsFort Wayne$203K
- Steven WiseIndianapolis$137K
- Majed KoleilatEvansville$122K
- Pinkus GoldbergIndianapolis$89K
- Douglas NeeldFort Wayne$77K
- Pooja PatelMerrillville$55K
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.