Zachary Guss, MD
Radiation Oncology · Spokane, WANPI 1497195762
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 100.0% of the total across 5 separate payments, which is the pattern of a clinician who attends manufacturer presentations rather than one with a consulting arrangement. AstraZeneca accounts for 64.7% of it on its own, with 2 other manufacturers making up the rest. Reporting peaked in 2019 at $330 and has fallen 90.6% since, to $31 in 2024.
Across 5 payments — averaging $77.23 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- AstraZeneca$250
- Novocure Inc.$105
- Skeletal Dynamics Inc$31
Across 54 payments — averaging $623.04 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.
- Merck$34K
What the payments were for
- Food & beverage$386100%
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 | 2 | $250 |
| Novocure Inc. | 2 | $105 |
| Skeletal Dynamics Inc | 1 | $31 |
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
$386 in reported general payments places this provider in the 55th percentile of 168 radiation oncology providers in Washington.
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 |
|---|---|---|
| Memantine Hcl | 18 | $469 |
| Triamcinolone Acetonide | 17 | $301 |
| Dexamethasone | 22 | $235 |
| Lidocaine Hcl ViscousLidocaine Hcl | 11 | $157 |
| Oxycodone Hcl | 13 | $117 |
| Hydrocodone-AcetaminophenHydrocodone/Acetaminophen | 14 | $109 |
| Lorazepam | 17 | $23 |
Paid to pharmacies, not to this prescriber.
Other radiation oncology in Spokane
- Bryan AgerSpokane$3K
- Orlan MacdonaldSpokane$1K
- Christopher LeeSpokane Valley$138K
- Vivek MehtaSeattle$120K
- Christopher LoiselleSeattle$63K
- Ramesh RenganSeattle$57K
- Jing ZengSeattle$37K
- Omar MianSeattle$22K
- Susan GuoTacoma$18K
- Richard HsiSeattle$18K
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.