Medicare Enrolled
Dr. Dickran Gulesserian, M.D.
Internal Medicine · Fresno, CA
Practice pattern: Mixed Practice
— Diverse clinical practice across multiple procedure types
Very High
DATA COVERAGE
Data in 4 of 4 federal sources
Measures public federal data availability — not provider quality
Informational, not a quality rating.
This page presents federal public records about Dr. Gulesserian from CMS (NPPES, Open Payments, Medicare Provider Utilization, PECOS). It is not medical advice, an endorsement, or a judgment of clinical quality. Always consult the provider directly and a licensed clinician for medical decisions. Read methodology →
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What this data tells you about Dr. Gulesserian
Dr. Dickran Gulesserian is an internal medicine specialist in Fresno, CA, with 19 years of NPI registration. Based on federal Medicare data, Dr. Gulesserian performed 68,526 Medicare services in 2023. These records do not provide a deduplicated patient total.
Between the years covered by Open Payments, Dr. Gulesserian received a total of $18,148 from 82 pharmaceutical and/or device companies across 888 payment records. A record can group multiple payments. These transfers are publicly reported through CMS Open Payments. Disclosure alone does not establish their effect on care. A reliable breakdown by payment category is not available in this snapshot. Patients may wish to discuss these relationships with their provider.
The Data Coverage level for Dr. Gulesserian is Very High — reflecting how much public federal data is available about this provider. Patients are encouraged to use this data as one of several factors when choosing a healthcare provider.
✓ 19 years of NPI registration
▲ Top 0% volume in CA
$18,148 industry payments
Medicare Practice Summary — 2023
Medicare Utilization ↗68,526
Medicare services
Top 0% in CA for internal medicine
Not available
Unique patients (not deduplicated)
$9
Avg. Medicare payment
Medicare patients only (65+ / disabled) · How to read this →
Top procedures by volume
Ranked by number of services performed for Medicare patients. Avg. submitted charge is what the provider billed; avg. Medicare payment is what CMS paid.
| Procedure | Volume | Avg. paid | Avg. submitted |
|---|---|---|---|
| Testosterone injection An injection of testosterone cypionate, a form of testosterone hormone. The dose is measured in milligrams. |
58,300 | $0 | $0 |
| Office visit, established patient (20-29 min) An office visit for an existing patient lasting between 20 and 29 minutes. The visit involves medical evaluation and management of the patient's condition. |
2,933 | $60 | $130 |
| Chronic care management, first 20 min/month This service covers the first 20 minutes of clinical staff time directed by a healthcare professional each calendar month to manage chronic conditions. |
1,511 | $45 | $85 |
| Annual wellness visit, follow-up A follow-up annual wellness visit that includes a personalized prevention plan of service. |
737 | $133 | $200 |
| Electrocardiogram (EKG), 12-lead A standard heart rhythm test using at least 12 leads to record electrical activity. A healthcare provider interprets the results and provides a written report. |
530 | $10 | $70 |
| Office visit, established patient (30-39 min) A follow-up office visit for an existing patient lasting between 30 and 39 minutes. The visit involves medical evaluation and management of the patient's condition. |
495 | $86 | $180 |
| Chronic care management, additional 20 min/month This service covers an extra 20 minutes of clinical staff time directed by a healthcare professional for managing two or more chronic conditions each calendar month. |
453 | $35 | $65 |
| Drug injection, under skin or into muscle A procedure involving the administration of a medication or substance via injection into the subcutaneous tissue or muscle. |
400 | $11 | $33 |
| Flu vaccine administration This procedure involves the administration of the influenza virus vaccine. It covers the process of delivering the vaccine to the patient. |
310 | $32 | $50 |
| Flu vaccine, high-dose High-dose seasonal influenza vaccine for adults aged 65 and older. Contains four times the antigen of standard-dose flu vaccines (60 mcg per strain), split-virus formulation, preservative-free, single-dose syringe. |
306 | $71 | $80 |
| Steroid injection (triamcinolone) A 10 mg injection of triamcinolone acetonide, a corticosteroid medication. This code specifies the drug and dosage administered. |
276 | $1 | $15 |
| Methylprednisolone acetate injection, 20 mg A 20 mg injection of methylprednisolone acetate, a corticosteroid medication. This code specifies the drug and dosage administered. |
232 | $4 | $15 |
| Echocardiogram, transthoracic An ultrasound of the heart that uses color to show blood flow, rate, direction, and valve function. |
207 | $147 | $571 |
| Vitamin B-12 injection An injection of vitamin B-12 (cyanocobalamin) with a dose of up to 1000 mcg. |
205 | $1 | $15 |
| Hospital follow-up visit, low complexity Follow-up hospital visit for an established patient with straightforward or low-level medical decision making. The visit requires at least 25 minutes of time spent on the day of service. |
187 | $40 | $65 |
| Regadenoson injection (Lexiscan) for heart stress test An injection of regadenoson, a medication used to stress the heart during diagnostic testing. |
172 | $43 | $70 |
| Technetium Tc-99m sestamibi diagnostic injection A diagnostic injection of technetium Tc-99m sestamibi used for imaging studies. |
122 | $90 | $400 |
| Joint injection, major joint Removal of fluid from a large joint and/or injection of medication into the joint space. |
89 | $51 | $130 |
| Home health plan of care certification Certification by a physician or allowed practitioner for Medicare-covered home health services under a home health plan of care. This includes contacting the home health agency and reviewing reports of patient status required by physicians. |
80 | $41 | $100 |
| Remote patient monitoring device, 30 days Initial setup of devices for remote monitoring of body functions with daily data transmission or alerts. This service covers the first 30 days of the monitoring period. |
76 | $41 | $80 |
| Ear wax removal A procedure to remove impacted ear wax from the ear canal. |
75 | $33 | $85 |
| Ultrasound of arm and leg arteries A non-invasive imaging test that uses sound waves to examine the blood vessels in the arms and legs. It evaluates blood flow and checks for blockages or other vascular issues. |
66 | $95 | $250 |
| Exercise or drug-induced heart stress test with ECG A heart stress test performed using exercise or medication while monitoring the electrocardiogram under physician supervision and review. |
65 | $51 | $285 |
| Remote patient monitoring management, 20 min/month Management based on results from remote vital sign monitoring for the first 20 minutes per calendar month. |
64 | $41 | $70 |
| Nuclear stress test of heart muscle A nuclear medicine imaging test that evaluates blood flow to the heart muscle at rest and during stress using a special camera. |
61 | $373 | $600 |
| Ultrasound of head and neck blood flow, bilateral An ultrasound exam that uses sound waves to visualize and assess blood flow in the vessels of both the head and the neck. |
57 | $163 | $400 |
| Transitional care management, high complexity Coordination of care for a patient transitioning from a short-term hospital stay or other facility to home or another care setting. This service addresses a high-complexity medical problem. |
54 | $216 | $380 |
| Remote pacemaker monitoring, 90 days Remote assessment of a pacemaker system, including single, dual, multiple lead, or leadless devices, performed up to 90 days apart. |
52 | $23 | $50 |
| New patient office visit (30-44 min) An initial office visit for a new patient lasting between 30 and 44 minutes. This code is used when the total time spent on the date of the encounter falls within this range. |
51 | $68 | $160 |
| Pneumococcal conjugate vaccine (PCV20) An intramuscular injection of the 20-valent pneumococcal conjugate vaccine. It is used to protect against diseases caused by Streptococcus pneumoniae bacteria. |
48 | $281 | $350 |
| Pneumonia vaccine administration This procedure involves the injection of a vaccine to protect against pneumococcal disease. It is administered by a healthcare provider. |
48 | $32 | $38 |
| Inhalation treatment for airway obstruction or sputum production A treatment involving the inhalation of medication to help clear airway obstructions or reduce sputum production. |
40 | $6 | $50 |
| Hospital discharge management, 30+ min This service covers the care provided by a physician or qualified healthcare professional on the day a patient is discharged from the hospital. It requires more than 30 minutes of total time spent on the day of discharge. |
40 | $94 | $150 |
| Initial hospital admission, high complexity Initial hospital inpatient or observation care for a new patient involving high-level medical decision making, with at least 75 minutes total time on the date of the encounter. |
38 | $137 | $280 |
| Aminophylline injection, up to 250 mg Administration of aminophylline medication via injection for a dose of up to 250 mg. |
35 | $7 | $15 |
| Annual wellness visit, initial visit A yearly appointment to review your health and create a personalized prevention plan. This initial visit focuses on preventive care and health assessment. |
22 | $172 | $250 |
| Office visit, established patient (10-19 min) An office visit for an existing patient lasting 10 to 19 minutes. The visit involves medical evaluation and management of the patient's condition. |
19 | $40 | $80 |
| Initial preventive physical examination, new Medicare beneficiary A comprehensive preventive health visit for new Medicare beneficiaries during their first 12 months of enrollment. The service is conducted as a face-to-face visit and is limited to preventive care. |
16 | $163 | $195 |
| Joint fluid aspiration or injection, small joint Removal of fluid from a small joint or injection of medication into a small joint. |
15 | $41 | $75 |
| Destruction of precancerous skin growth, 1 Removal of a single precancerous skin growth. This procedure destroys abnormal skin cells to prevent them from developing into cancer. |
14 | $47 | $150 |
| Simple drainage of skin abscess A minor procedure to drain a localized collection of pus from the skin. The abscess is opened to allow the fluid to escape and promote healing. |
13 | $103 | $140 |
| Wound closure utilizing tissue adhesive(s) only | 12 | $93 | $126 |
How to read this data: This reflects Medicare patients only (typically 65+). Payment amounts are what Medicare paid the provider, not your out-of-pocket cost. These counts do not measure clinical quality or years of experience.
0.4% high complexity
87.7% medium
11.9% routine
Industry Payment Transparency
Open Payments through 2024 ↗$18,148
Total received (2018-2024)
Avg $2,593/year across 7 years
Top 6% in CA for internal medicine
A higher payment rank reflects disclosed industry relationships (consulting, research, speaking) common among subspecialists — not wrongdoing.
82
Companies
888
Payment records
Payments are publicly reported; disclosure does not establish legality · Not evidence of wrongdoing · How to interpret →
Payment categories are unavailable while the source breakdown is being rebuilt. Company and year totals do not identify how much belongs to each category.
Payment trend by year
Annual totals from pharmaceutical and medical device companies.
2024
$1,691
2023
$2,097
2022
$2,651
2021
$3,343
2020
$2,259
2019
$3,260
2018
$2,846
Payments by company (2024)
AstraZeneca Pharmaceuticals LP
$307
ABIOMED
$204
Lexicon Pharmaceuticals, Inc.
$184
Novo Nordisk Inc
$169
Boehringer Ingelheim Pharmaceuticals, Inc.
$163
Novartis Pharmaceuticals Corporation
$83
Abbott Laboratories
$63
Boston Scientific Corporation
$54
Salix Pharmaceuticals, a division of Bausch Health US, LLC
$50
Amgen Inc.
$49
PFIZER INC.
$46
Phathom Pharmaceuticals, Inc.
$29
MDD US Operations, LLC
$27
Medtronic, Inc.
$24
SCILEX PHARMACEUTICALS INC.
$23
Exact Sciences Corporation
$23
Baxter Healthcare
$22
Xeris Pharmaceuticals, Inc.
$20
E.R. Squibb & Sons, L.L.C.
$20
Daiichi Sankyo Inc.
$20
Astellas Pharma US Inc
$19
Electromed, Inc.
$18
GlaxoSmithKline, LLC.
$18
Inspire Medical Systems, Inc.
$16
ABBVIE INC.
$15
Azurity Pharmaceuticals, Inc.
$14
Esperion Therapeutics, Inc.
$13
Top 3 companies account for 41.1% of 2024 payments
All-time payments by company (2018-2024) ›
Amgen Inc.
$2,216
AstraZeneca Pharmaceuticals LP
$1,827
Novo Nordisk Inc
$993
Janssen Pharmaceuticals, Inc
$969
GlaxoSmithKline, LLC.
$880
E.R. Squibb & Sons, L.L.C.
$830
Esperion Therapeutics, Inc.
$733
Boehringer Ingelheim Pharmaceuticals, Inc.
$700
Lilly USA, LLC
$699
ABBVIE INC.
$492
Abbott Laboratories
$490
PFIZER INC.
$466
Daiichi Sankyo Inc.
$436
Amarin Pharma Inc.
$417
Medtronic Vascular, Inc.
$376
Novartis Pharmaceuticals Corporation
$364
SANOFI-AVENTIS U.S. LLC
$348
Akcea Therapeutics, Inc.
$310
Astellas Pharma US Inc
$281
Takeda Pharmaceuticals U.S.A., Inc.
$265
Bayer HealthCare Pharmaceuticals Inc.
$252
Salix Pharmaceuticals, a division of Bausch Health US, LLC
$205
ABIOMED
$204
Flexion Therapeutics, Inc.
$184
Lexicon Pharmaceuticals, Inc.
$184
Biohaven Pharmaceuticals, Inc.
$183
Bayer Healthcare Pharmaceuticals Inc.
$173
Allergan, Inc.
$169
AbbVie Inc.
$146
Boston Scientific Corporation
$145
Ironwood Pharmaceuticals, Inc
$138
Philips Electronics North America Corporation
$111
Pacira Therapeutics, Inc.
$110
Radius Health, Inc.
$108
Nevro Corp.
$100
Otsuka America Pharmaceutical, Inc.
$95
ARBOR PHARMACEUTICALS, INC.
$81
Baxter Healthcare
$77
AbbVie, Inc.
$73
SK Life Science, Inc.
$71
Biohaven Pharmaceutical Holding Company Ltd.
$70
Kowa Pharmaceuticals America, Inc.
$63
Eisai Inc.
$63
Dexcom, Inc.
$63
Nestle HealthCare Nutrition Inc.
$60
Arbor Pharmaceuticals, Inc.
$55
Mannkind Corporation
$51
Mylan Specialty L.P.
$46
Exact Sciences Corporation
$41
IDORSIA PHARMACEUTICALS US INC
$41
FIDIA PHARMA USA INC.
$39
Scilex Pharmaceuticals Inc.
$37
Allergan Inc.
$36
Merck Sharp & Dohme Corporation
$36
SANOFI PASTEUR INC.
$34
Horizon Therapeutics plc
$30
Phathom Pharmaceuticals, Inc.
$29
IRONWOOD PHARMACEUTICALS, INC
$28
MDD US Operations, LLC
$27
Medtronic, Inc.
$24
Alnylam Pharmaceuticals Inc.
$24
Regeneron Healthcare Solutions, Inc.
$23
SCILEX PHARMACEUTICALS INC.
$23
Echosens North America, Inc.
$21
Xeris Pharmaceuticals, Inc.
$20
GE HealthCare
$20
Braemar Manufacturing, LLC
$20
Sanofi Pasteur Inc.
$19
Corcept Therapeutics
$19
Electromed, Inc.
$18
Seqirus USA Inc
$17
Stimwave Technologies Incorporated
$16
ARALEZ PHARMACEUTICALS US INC.
$16
Inspire Medical Systems, Inc.
$16
Horizon Pharma plc
$15
BIOTRONIK INC.
$14
Azurity Pharmaceuticals, Inc.
$14
Lundbeck LLC
$14
Tactile Systems Technology Inc
$12
JAZZ PHARMACEUTICALS INC.
$11
Nabriva Therapeutics, plc
$11
Bioventus LLC
$11
Top 3 companies account for 27.8% of all-time payments
Associated products mentioned in payments ›
(7999) SRC Und · (8874) inCourage · AFREZZA · AIMOVIG · AIRSUPRA · AMPLATZER Vascular Plug and Accs · ANDEXXA · ANORO · ANORO ELLIPTA · Advisa · Aimovig · BASAGLAR · BELSOMRA · BREZTRI · BREZTRI AEROSPHERE · BRILINTA · Belviq · CAMZYOS · CHANTIX · COLOGUARD · Cardiac Monitoring Suite · Cologuard Collection Kit · Corlanor · DUZALLO · Dayvigo · Dexcom G6 Transmitter · Durolane · ELIQUIS · ELYXYB - CELECOXIB · EMGALITY · ENTRESTO · EUCRISA · EVENITY · Edarbi · Endurant · FARXIGA · FASENRA · FLUBLOK QUADRIVALENT · FLUZONE HIGH-DOSE · FLUZONE QUADRIVALENT · FREESTYLE LIBRE 2 · FREESTYLE LIBRE 3 · FibroScan · Fixate · Flexitouch Plus · Fluad Quadrivalent · FreeStyle Libre 2 · GVOKE HYPOPEN · Gocovri · HORIZANT · HUMALOG · Hillrom - Cardiac Ambulatory Monitor · Hillrom - Life 2000 Ventilation System · Hillrom - Monarch Airway Clearance System · Humira · Hymovis · INCRUSE · INJECTAFER · INSPIRE · INVOKANA · Impella · Inpefa · JANUVIA · JARDIANCE · KRYSTEXXA · Kerendia · Korlym · LEQVIO · LINZESS · LYRICA · Linzess · Livalo · MITRACLIP · MOUNJARO · MULTAQ · MYRBETRIQ · Mavyret · Micra · MitraClip System · Motegrity · NEXLETOL · NEXLIZET · NURTEC ODT · OFEV · ONPATTRO · Omnia · Otezla · Ozempic · PAXLOVID · PENNSAID · PRADAXA · PRALUENT · PRALUENT ALIROCUMAB INJECTION · PREVNAR - 13 · PREVNAR 20 · Prolia · QULIPTA · QUVIVIQ · Quadra Assura CRT Defibrillator · REVEAL LINQ · REXULTI · REYVOW · RYBELSUS · Repatha · Respiratoriy Care Undiv · Reveal LINQ · Rybelsus · SHINGRIX · SMARTVEST · SPIRIVA RESPIMAT · STIOLTO RESPIMAT · SUNOSI · SYMBICORT · Senza · Senza Spinal Cord Stimulation System · StimQ Receiver Stimulator Kit Channel A US w Receiver · TEGSEDI · TOUJEO · TRADJENTA · TRELEGY ELLIPTA · TRINTELLIX · TRULICITY · TYRX · Tresiba · Trintellix · Tymlos · UBRELVY · Uloric · VIBERZI · VIIBRYD · VOQUEZNA · VRAYLAR · Vascepa · Veozah · Victoza · WATCHMAN · Wegovy · Wellcentive Undiv · XARELTO · XIFAXAN · XIFIXAN · Xenleta · Yupelri · ZENPEP · ZONTIVITY · ZTLido · Zilretta
Should you be concerned? Industry payments are disclosed through CMS Open Payments. Disclosure alone does not establish their purpose, legality, or effect on care. What matters is whether a recommended drug or device appears in your doctor's payment records. If so, consider asking your doctor about it. How to interpret this data →
Geographic Context
Internal medicine physicians in nearby ZIP areas
493
County median income
$71,434
Nearest hospital to ZIP centroid (approximate)
SAINT AGNES MEDICAL CENTER
0.0 mi
0.0 mi
Data Sources
| Provider Registry | ✓ NPPES | NPPES snapshot; verify current record |
| Medicare Enrollment | ✓ PECOS | PECOS snapshot |
| Practice Data | ✓ Medicare Util. | Annual (CY lag) |
| Industry Payments | ✓ Open Payments | CY 2024 |
| Disciplinary History | — Not included | N/A |
This provider has data in 4 of 4 available federal datasets, with a Data Coverage level of Very High. This reflects how much public data is available about a provider. How we calculate this →
Summary
Dr. Gulesserian is a mixed practice specialist, with above-average Medicare volume (top 0% in CA), with 19 years of NPI registration.
This summary is auto-generated from federal data, describing data availability and patterns. Read our methodology →
Frequently Asked Questions
Is Dr. Gulesserian experienced with testosterone injection?
Based on Medicare claims data, Dr. Gulesserian performed 58,300 testosterone injection services. These records cover Medicare fee-for-service activity, including eligible younger beneficiaries; they do not measure total practice volume or clinical quality.
Does Dr. Gulesserian receive payments from pharmaceutical companies?
Yes. Dr. Gulesserian received a total of $18,148 from 82 companies across 888 payment records. A record can group multiple payments. These transfers are publicly disclosed through CMS Open Payments. Disclosure alone does not establish their legality or effect on care. Patients may wish to ask their doctor about these relationships, especially if a recommended drug or device appears in the payment records.
How do Dr. Gulesserian's costs compare to other internal medicine physicians in Fresno?
Dr. Gulesserian's average Medicare payment per service is $9. Note that these figures represent what Medicare pays, not your out-of-pocket cost, which depends on your specific insurance plan and deductible. Procedure-level data above shows both what was submitted and what Medicare paid for each service type.
What does Data Coverage mean?
Data Coverage (currently Very High for Dr. Gulesserian) measures how much public federal data is available about a provider. It is not a quality rating. A "Very High" or "High" level means the provider has data across multiple federal sources (NPPES, PECOS, Medicare Utilization, Open Payments), indicating the presence of registry, enrollment, activity or payment records, not verified experience or clinical quality. A "Low" or "Moderate" level may simply mean the provider is newer, does not see Medicare patients, or has not received any industry payments — none of which are inherently negative. Read our full methodology →
Is this data up to date?
Source publication dates and the snapshots loaded on this site can differ. Rebuilding a page does not refresh its source records. Check the Medicare reporting year and the payment interval shown above; consult the linked official sources for newer releases and current registry details. See our data freshness policy →
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About this page
This page combines public CMS records with calculated summaries and explanatory procedure labels. These transformations are not verbatim federal records. Sources: NPPES ↗, Open Payments ↗, Medicare Provider Utilization ↗, and PECOS. Publication is mandated by the Physician Payments Sunshine Act (§6002 ACA, 42 U.S.C. §1320a-7h) and the Freedom of Information Act.
This page is not medical advice, an endorsement, a recommendation, or a quality rating. Data Coverage reflects data completeness — how much federal information exists for this provider — not clinical performance, patient outcomes, or quality of care. Always verify information directly with the provider and consult a licensed clinician before making medical decisions.
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