Arnulfo Santana Santana, MD
Pulmonary Disease · Caguas, PRNPI 1932241494
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 97.8% of the total across 171 separate payments, which is the pattern of a clinician who attends manufacturer presentations rather than one with a consulting arrangement. 17 manufacturers reported payments, led by AstraZeneca at 43.2% of the total.
Across 171 payments — averaging $32.95 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- AstraZeneca$2K
- GSK$1K
- Johnson & Johnson$360
- Boehringer Ingelheim$360
- Merck$307
- Genentech USA, Inc.$237
- plus $866 from 11 others
What the payments were for
- Food & beverage$5,51298%
- Education$1232%
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 |
|---|---|---|
| AstraZeneca | 93 | $2,432 |
| GSK | 40 | $1,072 |
| Johnson & Johnson | 4 | $360 |
| Boehringer Ingelheim | 9 | $360 |
| Merck | 6 | $307 |
| Genentech USA, Inc. | 4 | $237 |
| Jazz Pharmaceuticals Inc. | 2 | $208 |
| E.r. Squibb & Sons, L.L.C. | 1 | $119 |
| United Therapeutics Corporation | 2 | $102 |
| Actelion Pharmaceuticals US, Inc. | 1 | $100 |
| Boston Scientific | 1 | $90 |
| ZOLL Services LLC (a/k/a ZOLL Lifecor Corp) | 1 | $70 |
| Sanofi | 2 | $55 |
| Takeda Pharmaceuticals U.S.A., Inc. | 2 | $39 |
| Grifols USA, LLC | 1 | $34 |
| Eli Lilly Export S.A. Puerto Rico Branch | 1 | $25 |
| Liquidia Technologies, Inc. | 1 | $24 |
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
$5,635 in reported general payments places this provider in the 75th percentile of 138 pulmonary disease providers in Puerto Rico.
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 |
|---|---|---|
| Trelegy ElliptaFluticasone/Umeclidin/Vilanter | 273 | $182,759 |
| Pirfenidone | 34 | $106,361 |
| Breztri AerosphereBudesonide/Glycopyr/Formoterol | 148 | $97,112 |
| Budesonide-Formoterol FumarateBudesonide/Formoterol Fumarate | 341 | $84,400 |
| Fasenra PenBenralizumab | 14 | $77,937 |
| SymbicortBudesonide/Formoterol Fumarate | 250 | $58,123 |
| Spiriva RespimatTiotropium Bromide | 88 | $48,202 |
| Breo ElliptaFluticasone/Vilanterol | 94 | $39,027 |
| XareltoRivaroxaban | 17 | $11,527 |
| Spiriva HandihalerTiotropium Bromide | 21 | $11,007 |
| Azelastine-FluticasoneAzelastine/Fluticasone | 68 | $7,201 |
| Stiolto RespimatTiotropium Br/Olodaterol Hcl | 11 | $5,317 |
| Albuterol Sulfate HfaAlbuterol Sulfate | 111 | $4,576 |
| Wixela InhubFluticasone Propion/Salmeterol | 28 | $3,874 |
| Prednisolone Sodium Phosphate | 129 | $3,473 |
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 |
|---|---|---|
| GSKTrelegy Ellipta, Breo Ellipta | $1,072 | $221,786367 claims |
| AstraZenecaBreztri Aerosphere, Symbicort | $2,432 | $155,236398 claims |
| Boehringer IngelheimSpiriva Respimat, Stiolto Respimat | $360 | $53,52099 claims |
| Johnson & JohnsonXarelto | $360 | $11,52717 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 75th percentile of 138 pulmonary disease providers in Puerto Rico.
Other pulmonary disease in Caguas
- Rosangela Fernandez MederoCaguas$5K
- Juan Garcia PueblaCaguas$5K
- Carissa Cruz BerriosCaguas$4K
- Jose Valles QuinonesCaguas$3K
- Alvaro Aranda RodriguezGuaynabo$725K
- Luis Garcia BarretoCoamo$393K
- Luis Nieves GarrasteguiRio Piedras$121K
- Jahaira Serrano DominguezArecibo$102K
- William Villanueva-BosqueArecibo$67K
- Domingo Chardon FelicianoPonce$45K
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.