Alfonso Ramirez, MD
Family Medicine · Dallas, TXNPI 1730158718
Payments from drug & device makers
Across 113 payments — averaging $19.34 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Boehringer Ingelheim$379
- Novo Nordisk$378
- Amarin Pharma, Inc.$285
- Pfizer$253
- Gilead$139
- Merck$127
- plus $625 from 14 others
What the payments were for
- Food & beverage$2,185100%
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 |
|---|---|---|
| Boehringer Ingelheim | 20 | $379 |
| Novo Nordisk | 26 | $378 |
| Amarin Pharma, Inc. | 15 | $285 |
| Pfizer | 11 | $253 |
| Gilead | 2 | $139 |
| Merck | 9 | $127 |
| Teva Pharmaceuticals USA, Inc. | 1 | $121 |
| AstraZeneca | 7 | $103 |
| Lilly USA, LLC | 5 | $94 |
| Exact Sciences | 4 | $74 |
| Amgen | 3 | $50 |
| VBI Vaccine (delaware) Inc. | 2 | $40 |
| Abbott | 1 | $23 |
| Bayer | 1 | $21 |
| Hologic Sales And Service, LLC | 1 | $21 |
| GSK | 1 | $20 |
| Arbor Pharmaceuticals, Inc. | 1 | $15 |
| Salix Pharmaceuticals, A Division Of Bausch Health US, LLC | 1 | $15 |
| AbbVie | 1 | $15 |
| Johnson & Johnson | 1 | $15 |
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
$2,185 in reported general payments places this provider in the 70th 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 |
|---|---|---|
| JardianceEmpagliflozin | 114 | $183,142 |
| RybelsusSemaglutide | 39 | $68,109 |
| JanuviaSitagliptin Phosphate | 36 | $50,899 |
| FarxigaDapagliflozin Propanediol | 27 | $34,028 |
| Tresiba Flextouch U-200Insulin Degludec | 27 | $29,875 |
| Toujeo SolostarInsulin Glargine,hum.Rec.Anlog | 39 | $27,892 |
| OzempicSemaglutide | 14 | $25,145 |
| TradjentaLinagliptin | 20 | $25,079 |
| LinzessLinaclotide | 40 | $24,264 |
| Tresiba Flextouch U-100Insulin Degludec | 34 | $19,444 |
| JanumetSitagliptin Phos/Metformin Hcl | 13 | $17,235 |
| Synjardy XrEmpagliflozin/Metformin Hcl | 17 | $11,690 |
| SymbicortBudesonide/Formoterol Fumarate | 24 | $10,208 |
| Lantus SolostarInsulin Glargine,hum.Rec.Anlog | 50 | $8,920 |
| Breztri AerosphereBudesonide/Glycopyr/Formoterol | 13 | $8,608 |
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, Tradjenta, Synjardy Xr | $379 | $219,911151 claims |
| Novo NordiskRybelsus, Ozempic | $378 | $93,25453 claims |
| MerckJanuvia, Janumet | $127 | $68,13549 claims |
| AstraZenecaFarxiga, Symbicort, Breztri Aerosphere | $103 | $52,84564 claims |
| AbbVieLinzess | $15 | $24,26440 claims |
| Lilly USA, LLCHumulin 70-30 | $94 | $8,21555 claims |
| GSKBreo Ellipta, Arexvy | $20 | $7,73925 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 70th percentile of 8,760 family medicine providers in Texas.
Other family medicine in Dallas
- Thomas KingDallas$12M
- Jennifer ZonDallas$5.9M
- Chrisette DharmagunaratneDallas$5.6M
- Michele ReynoldsDallas$3.8M
- Shiwali RaiDallas$2.8M
- Douglas DenhamSan Antonio$68.5M
- Vicki MillerPasadena$58.3M
- Hareshkumar BogharaDesoto$30.3M
- Earl MartinTomball$30.1M
- Lisa HollowayHouston$30.1M
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.