America Ramirez Sierra, NP
Nurse Practitioner · Tuscan, AZNPI 1699411868
Payments from drug & device makers
What this record shows
This record is dominated by food and beverage: $14,955 of the $20,865 with a category attached, or 71.7%. 21 manufacturers reported payments, led by Nalu Medical, Inc. at 30.1% of the total. Reporting peaked in 2024 at $9,660 and has fallen 79.3% since, to $1,996 in 2025. Among nurse practitioner clinicians in AZ with any reported payments, this total sits in the top 5% — high for the specialty, which is a reason to read the composition above rather than the number alone.
Across 357 payments — averaging $58.45 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Nalu Medical, Inc.$6K
- Saluda Medical Americas, Inc.$5K
- Boston Scientific$2K
- Medtronic$2K
- Abbott$2K
- Nevro Corp.$1K
- plus $2K from 15 others
What the payments were for
- Consulting fees$1,2756%
- Travel & lodging$4,58122%
- Food & beverage$14,95572%
- Education$540%
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 |
|---|---|---|
| Nalu Medical, Inc. | 141 | $6,287 |
| Saluda Medical Americas, Inc. | 62 | $4,943 |
| Boston Scientific | 29 | $2,423 |
| Medtronic | 27 | $2,156 |
| Abbott | 17 | $1,502 |
| Nevro Corp. | 21 | $1,090 |
| Spinal Simplicity, LLC | 11 | $1,082 |
| SPR Therapeutics, Inc | 4 | $268 |
| Collegium Pharmaceutical, Inc. | 15 | $241 |
| AbbVie | 3 | $190 |
| Vertos Medical, Inc. | 3 | $159 |
| GRT US Holding, Inc. | 2 | $134 |
| Valinor Pharma, LLC | 5 | $103 |
| Salix Pharmaceuticals, A Division Of Bausch Health US, LLC | 6 | $89 |
| Globus Medical | 3 | $53 |
| Ferring Pharmaceuticals Inc. | 2 | $39 |
| Vertex | 2 | $37 |
| Curonix LLC | 1 | $21 |
| Pacira Pharmaceuticals Incorporated | 1 | $20 |
| Radius Health, Inc. | 1 | $16 |
| Averitas Pharma 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.
- Evoke$4,103
- Nalu Neurostimulation System$2,749
- Intracept$1,025
- HA MINUTEMAN G3-R$954
- INTELLIS ADAPTIVESTIM$880
- SYNCHROMEDII$610
- PROCLAIM$536
- Senza$416
- Superion Indirect Decompression System$266
- ETERNA$154
- mild Device Kit$127
- BOTOX$116
- Qutenza$115
- SPRINT PNS System$102
How this compares
$20,865 in reported general payments places this provider in the 95th percentile of 1,719 nurse practitioner providers in Arizona.
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 |
|---|---|---|
| Oxycodone-AcetaminophenOxycodone Hcl/Acetaminophen | 744 | $26,196 |
| Hydrocodone-AcetaminophenHydrocodone/Acetaminophen | 734 | $22,320 |
| Xtampza ErOxycodone Myristate | 56 | $21,825 |
| MovantikNaloxegol Oxalate | 39 | $16,739 |
| Hysingla ErHydrocodone Bitartrate | 24 | $12,463 |
| Buprenorphine | 52 | $10,551 |
| BelbucaBuprenorphine Hcl | 15 | $9,996 |
| OxycontinOxycodone Hcl | 18 | $9,021 |
| Pregabalin | 356 | $8,676 |
| Oxycodone Hcl | 478 | $7,339 |
| Gabapentin | 398 | $7,033 |
| Morphine Sulfate ErMorphine Sulfate | 235 | $6,412 |
| Tramadol Hcl | 297 | $3,620 |
| Morphine Sulfate | 107 | $3,598 |
| Lidocaine | 46 | $3,593 |
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 |
|---|---|---|
| Collegium Pharmaceutical, Inc.Xtampza Er, Belbuca | $241 | $31,82171 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 95th percentile of 1,719 nurse practitioner providers in Arizona.
Other nurse practitioner in Tuscan
- Ann MooreGlendale$208K
- Sandra KurtinTucson$201K
- Kristen HerzogScottsdale$162K
- Krista ArredondoChandler$133K
- Shannon MorgensternOro Valley$71K
- Helena In't VeldPhoenix$64K
- Steven KalfusChandler$43K
- Dustin NickersonPhoenix$39K
- Shannon BoffeliFlagstaff$31K
- Kelley RoneScottsdale$29K
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.