Alejandro Lerma, MD
Family Medicine · San Antonio, TXNPI 1679892566
Payments from drug & device makers
Across 475 payments — averaging $18.15 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Novo Nordisk$2K
- AbbVie$1K
- Amgen$754
- Lilly USA, LLC$753
- Johnson & Johnson$708
- Astellas Pharma US Inc$466
- plus $3K from 31 others
What the payments were for
- Food & beverage$8,44298%
- Education$1802%
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 |
|---|---|---|
| Novo Nordisk | 93 | $1,852 |
| AbbVie(2 entities) | 105 | $1,383 |
| Amgen(2 entities) | 42 | $754 |
| Lilly USA, LLC | 36 | $753 |
| Johnson & Johnson | 45 | $708 |
| Astellas Pharma US Inc | 21 | $466 |
| AstraZeneca(2 entities) | 24 | $406 |
| Sumitomo Pharma America, Inc. | 8 | $238 |
| Bayer | 6 | $231 |
| Merck | 13 | $215 |
| Salix Pharmaceuticals, A Division Of Bausch Health US, LLC | 13 | $179 |
| Amarin Pharma, Inc. | 10 | $168 |
| Dexcom, Inc. | 1 | $150 |
| Novartis | 5 | $136 |
| Abbott | 6 | $125 |
| Smith+Nephew | 1 | $114 |
| Boehringer Ingelheim | 6 | $92 |
| Nestle Healthcare Nutrition Inc. | 5 | $91 |
| E.r. Squibb & Sons, L.L.C. | 4 | $80 |
| GSK | 4 | $68 |
| Aimmune Therapeutics, Inc. | 3 | $44 |
| Sanofi-aventis U.S. LLC | 3 | $44 |
| Teva Pharmaceuticals USA, Inc. | 3 | $37 |
| Pfizer | 2 | $36 |
| Sunovion Pharmaceuticals Inc. | 2 | $36 |
| Dynavax Technologies Corporation | 2 | $27 |
| Genentech USA, Inc. | 2 | $25 |
| Exact Sciences | 1 | $24 |
| Cvrx, Inc. | 1 | $20 |
| Radius Health, Inc. | 1 | $16 |
| VBI Vaccine (delaware) Inc. | 1 | $16 |
| Biohaven Pharmaceutical Holding Company Ltd. | 1 | $16 |
| Cumberland Pharmaceuticals, Inc. | 1 | $16 |
| Shield Therapeutics Inc | 1 | $15 |
| Shire North American Group Inc | 1 | $14 |
| Currax Pharmaceuticals LLC | 1 | $14 |
| Otsuka America Pharmaceutical, Inc. | 1 | $13 |
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.
- Ozempic$344
- XARELTO$250
- RYBELSUS$221
- DEXCOM G7 GSS (161)$150
- DEXCOM STELO GLUCOSE BIOSENSOR$150
- MOUNJARO$125
- JARDIANCE$125
- GEMTESA$125
- Kerendia$125
- AIMOVIG$114
- COLLAGENASE SANTYL$114
How this compares
$8,622 in reported general payments places this provider in the 90th percentile of 8,760 family medicine providers in Texas.
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 |
|---|---|---|
| OzempicSemaglutide | 236 | $323,962 |
| JardianceEmpagliflozin | 140 | $231,233 |
| Janumet XrSitagliptin Phos/Metformin Hcl | 93 | $125,665 |
| RybelsusSemaglutide | 49 | $105,255 |
| Soliqua 100-33Insulin Glargine/Lixisenatide | 94 | $97,586 |
| ZenpepLipase/Protease/Amylase | 51 | $97,494 |
| GemtesaVibegron | 53 | $73,276 |
| JanuviaSitagliptin Phosphate | 43 | $69,651 |
| LinzessLinaclotide | 53 | $67,272 |
| EliquisApixaban | 64 | $59,231 |
| Bydureon BciseExenatide Microspheres | 19 | $48,059 |
| TrulicityDulaglutide | 23 | $48,000 |
| Breztri AerosphereBudesonide/Glycopyr/Formoterol | 44 | $44,645 |
| VraylarCariprazine Hcl | 29 | $42,305 |
| Xigduo XrDapaglifloz Propaned/Metformin | 28 | $40,622 |
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 |
|---|---|---|
| Novo NordiskOzempic, Rybelsus | $1,852 | $429,217285 claims |
| Boehringer IngelheimJardiance, Synjardy Xr, Tradjenta, Synjardy, Trijardy Xr | $92 | $369,173266 claims |
| MerckJanumet Xr, Januvia | $215 | $195,315136 claims |
| AbbVieLinzess, Vraylar, Creon | $1,383 | $137,668109 claims |
| Sanofi-aventis U.S. LLCSoliqua 100-33 | $44 | $97,58694 claims |
| Aimmune Therapeutics, Inc.Zenpep | $44 | $97,49451 claims |
| Lilly USA, LLCTrulicity, Mounjaro | $753 | $80,19346 claims |
| AstraZenecaBreztri Aerosphere, Farxiga, Symbicort | $406 | $78,11377 claims |
| Sumitomo Pharma America, Inc.Gemtesa | $238 | $73,27653 claims |
| PfizerEliquis | $36 | $59,23164 claims |
| Astellas Pharma US IncMyrbetriq | $466 | $34,19833 claims |
| GSKTrelegy Ellipta | $68 | $22,65625 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 90th percentile of 8,760 family medicine providers in Texas.
Other family medicine in San Antonio
- Douglas DenhamSan Antonio$68.5M
- George AtieeSan Antonio$19.9M
- Leonel ReyesSan Antonio$4.3M
- Brian MacgillivraySan Antonio$3.2M
- Juan GarzaSan Antonio$2.5M
- Vicki MillerPasadena$58.3M
- Hareshkumar BogharaDesoto$30.3M
- Earl MartinTomball$30.1M
- Lisa HollowayHouston$30.1M
- William SegerFort Worth$27.5M
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.