Walter Guarino
Psychiatry · Vienna, VANPI 1366563199
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 99.7% of the total across 265 separate payments, which is the pattern of a clinician who attends manufacturer presentations rather than one with a consulting arrangement. 16 manufacturers reported payments, led by AbbVie at 24.8% of the total. Reporting peaked in 2019 at $2,156 and has fallen 73.4% since, to $573 in 2025. Among psychiatry clinicians in VA 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 265 payments — averaging $28.89 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- AbbVie$2K
- Lundbeck LLC$1K
- ITI, Inc. (d/b/a Intra-cellular Therapies, Inc.)$1K
- Otsuka America Pharmaceutical, Inc.$1K
- Takeda Pharmaceuticals U.S.A., Inc.$700
- Sunovion Pharmaceuticals Inc.$401
- plus $1K from 10 others
What the payments were for
- Food & beverage$7,631100%
- Education$250%
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 |
|---|---|---|
| AbbVie(2 entities) | 81 | $1,897 |
| Lundbeck LLC | 67 | $1,437 |
| ITI, Inc. (d/b/a Intra-cellular Therapies, Inc.) | 22 | $1,087 |
| Otsuka America Pharmaceutical, Inc. | 28 | $1,004 |
| Takeda Pharmaceuticals U.S.A., Inc. | 27 | $700 |
| Sunovion Pharmaceuticals Inc. | 6 | $401 |
| Axsome Therapeutics, Inc. | 7 | $283 |
| Neurocrine Biosciences, Inc. | 3 | $240 |
| Alkermes, Inc. | 7 | $131 |
| Bausch Health US, LLC | 7 | $129 |
| Teva Pharmaceuticals USA, Inc. | 1 | $125 |
| Corium, LLC | 2 | $121 |
| Arbor Pharmaceuticals, Inc. | 3 | $41 |
| Neos Therapeutics, LP | 2 | $29 |
| Eisai Inc. | 1 | $21 |
| Adlon Therapeutics L.p. | 1 | $11 |
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
$7,656 in reported general payments places this provider in the 90th percentile of 884 psychiatry providers in Virginia.
Most prescribed under Part D
| Drug | Claims | Cost to plans & patients |
|---|---|---|
| Lorazepam | 34 | $425 |
| Mirtazapine | 11 | $286 |
| Dextroamphetamine-AmphetamineDextroamphetamine/Amphetamine | 12 | $71 |
Paid to pharmacies, not to this prescriber.
Other psychiatry in Vienna
- Niku SinghFalls Church$2.5M
- David ScheidererRoanoke$2.4M
- Kent McDanielGlen Allen$2.1M
- Jasdeep MiglaniManassas$958K
- David SpiegelNorfolk$565K
- William YetterVirginia Beach$312K
- Anita ClaytonCharlottesville$260K
- Robert GardellaStaunton$201K
- Timothy KaneStaunton$162K
- Ralph McKenzieRoanoke$161K
Where these figures come from
- Payments: CMS Open Payments, program years 2019–2025 (publication P06302026_06032026).
- Identity: NPPES NPI Registry, July 2026.