Alex Llarena, MD
Internal Medicine · Fernandina Beach, FLNPI 1326060203
Payments from drug & device makers
Across 95 payments — averaging $30.48 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Amgen$412
- Novo Nordisk$389
- Amarin Pharma, Inc.$334
- GSK$294
- Boston Scientific$260
- Abbott$194
- plus $1K from 18 others
What the payments were for
- Food & beverage$2,86499%
- Education$321%
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 |
|---|---|---|
| Amgen | 8 | $412 |
| Novo Nordisk | 20 | $389 |
| Amarin Pharma, Inc. | 9 | $334 |
| GSK | 7 | $294 |
| Boston Scientific | 3 | $260 |
| Abbott | 4 | $194 |
| AbbVie | 7 | $184 |
| Abiomed | 1 | $129 |
| Lilly USA, LLC | 5 | $118 |
| Dexcom, Inc. | 2 | $116 |
| AstraZeneca | 6 | $85 |
| Novartis | 3 | $67 |
| Supernus Pharmaceuticals, Inc. | 4 | $67 |
| Sanofi-aventis U.S. LLC | 4 | $63 |
| Boehringer Ingelheim | 2 | $33 |
| Merck | 2 | $25 |
| Salix Pharmaceuticals, A Division Of Bausch Health US, LLC | 1 | $25 |
| Sumitomo Pharma America, Inc. | 1 | $21 |
| Scilex Pharmaceuticals Inc. | 1 | $14 |
| Astellas Pharma US Inc | 1 | $14 |
| Avanir Pharmaceuticals, Inc. | 1 | $14 |
| Idorsia Pharmaceuticals US Inc | 1 | $13 |
| Ironwood Pharmaceuticals, Inc | 1 | $13 |
| Kowa Pharmaceuticals America, Inc. | 1 | $12 |
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.
- Vascepa$278
- Repatha$218
- Impella$129
- FreeStyle Libre 2$128
- TRELEGY ELLIPTA$114
- AREXVY$112
- RYBELSUS$109
- AIMOVIG$106
- DEXCOM G6 TRANSMITTER$102
How this compares
$2,896 in reported general payments places this provider in the 80th percentile of 8,530 internal medicine providers in Florida.
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 |
|---|---|---|
| JardianceEmpagliflozin | 103 | $113,409 |
| OzempicSemaglutide | 46 | $83,633 |
| EliquisApixaban | 65 | $76,503 |
| TrulicityDulaglutide | 45 | $57,847 |
| EntrestoSacubitril/Valsartan | 16 | $21,784 |
| Breo ElliptaFluticasone/Vilanterol | 27 | $18,623 |
| Tresiba Flextouch U-100Insulin Degludec | 18 | $18,216 |
| Trelegy ElliptaFluticasone/Umeclidin/Vilanter | 14 | $16,582 |
| MounjaroTirzepatide | 13 | $14,138 |
| XareltoRivaroxaban | 18 | $13,190 |
| VascepaIcosapent Ethyl | 22 | $13,090 |
| Anoro ElliptaUmeclidinium Brm/Vilanterol Tr | 12 | $7,628 |
| Rosuvastatin Calcium | 585 | $6,390 |
| SynthroidLevothyroxine Sodium | 59 | $4,716 |
| Ezetimibe | 189 | $3,124 |
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 |
|---|---|---|
| Boehringer IngelheimJardiance | $33 | $113,409103 claims |
| Novo NordiskOzempic | $389 | $83,63346 claims |
| Lilly USA, LLCTrulicity, Mounjaro | $118 | $71,98658 claims |
| GSKBreo Ellipta, Trelegy Ellipta, Anoro Ellipta | $294 | $42,83353 claims |
| NovartisEntresto | $67 | $21,78416 claims |
| AbbVieSynthroid | $184 | $4,71659 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 80th percentile of 8,530 internal medicine providers in Florida.
Other internal medicine in Fernandina Beach
- Yaneicy Gonzalez RojasCoral Gables$93.5M
- Juan Carlos RondonHollywood$66.8M
- Jaynier MoyaPembroke Pines$45.4M
- Mark KutnerMiami$35.7M
- Gilberto JimenezHialeah$35.6M
- Mira BaronWest Palm Beach$29.6M
- William SanchezHialeah$28.9M
- Nelia Sanchez-CrespoHollywood$28.8M
- Kwabena AyesuOrlando$27.6M
- Michael DeverWindermere$24M
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.