Carlos Micames, MD
Gastroenterology · Mayaguez, PRNPI 1598787491
Payments from drug & device makers
What this record shows
The money is spread across several categories — consulting fees (37.6%), speaking fees and food and beverage — rather than concentrated in one kind of arrangement. 19 manufacturers reported payments, led by AbbVie at 38.5% of the total. Reporting peaked in 2023 at $9,667 and has fallen 76.9% since, to $2,235 in 2025. Among gastroenterology clinicians in PR 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 98 payments — averaging $220.02 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- AbbVie$8K
- Boston Scientific$8K
- E.r. Squibb & Sons, L.L.C.$3K
- Olympus Latin America, Inc.$447
- Janssen Scientific Affairs, LLC$291
- Madrigal Pharmaceuticals$254
- plus $1K from 13 others
What the payments were for
- Consulting fees$8,10038%
- Speaking & faculty fees$7,80036%
- Food & beverage$5,63426%
- Education$280%
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 |
|---|---|---|
| AbbVie(2 entities) | 34 | $8,310 |
| Boston Scientific | 7 | $7,949 |
| E.r. Squibb & Sons, L.L.C. | 21 | $2,852 |
| Olympus Latin America, Inc. | 7 | $447 |
| Janssen Scientific Affairs, LLC | 3 | $291 |
| Madrigal Pharmaceuticals | 2 | $254 |
| Johnson & Johnson(2 entities) | 2 | $246 |
| Gilead | 3 | $213 |
| Apollo Endosurgery US Inc | 6 | $191 |
| Intercept Pharmaceuticals, Inc. | 1 | $125 |
| Lilly USA, LLC | 1 | $125 |
| Steris Corporation | 1 | $101 |
| Merck | 1 | $98 |
| Pfizer Pharmaceuticals LLC | 1 | $78 |
| Creo Medical Inc. | 1 | $69 |
| Micro-tech Endoscopy USA, Inc. | 1 | $66 |
| PBG Puerto Rico LLC | 3 | $57 |
| Olympus America Inc. | 1 | $55 |
| Organon | 2 | $35 |
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.
- SPYGLASS$5,100
- Rinvoq$3,575
- Skyrizi$2,906
- GENERAL - BILIARY DEVICES$1,800
- ORISE$900
- Synthroid$550
- STELARA$484
- ZEPOSIA$386
- EVIS EXERA II ULTRASOUND GASTROVIDEOSCOPE$264
- REZDIFFRA$254
- ELIQUIS$226
- OCALIVA$125
- OMVOH$125
- Livdelzi$125
- EVIS EXERA III COLONOVIDEOSCOPE$125
- OPDIVO$120
- Tremfya$117
- Mavyret$116
- Humira$110
- Padlock Clip$101
How this compares
$21,562 in reported general payments places this provider in the 95th percentile of 198 gastroenterology 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 |
|---|---|---|
| CreonLipase/Protease/Amylase | 162 | $209,314 |
| Xeljanz XrTofacitinib Citrate | 16 | $91,895 |
| Humira(Cf) PenAdalimumab | 13 | $87,723 |
| LinzessLinaclotide | 36 | $20,164 |
| Mesalamine | 27 | $14,872 |
| SuprepSodium, Potassium,mag Sulfates | 122 | $14,399 |
| Sucralfate | 85 | $8,864 |
| DexilantDexlansoprazole | 25 | $7,802 |
| Dexlansoprazole DrDexlansoprazole | 33 | $7,429 |
| Sod Sulf-Potass Sulf-Mag SulfSodium, Potassium,mag Sulfates | 38 | $3,113 |
| Esomeprazole Magnesium | 121 | $2,830 |
| Ursodiol | 28 | $2,715 |
| Lubiprostone | 16 | $1,769 |
| LoperamideLoperamide Hcl | 17 | $714 |
| Pantoprazole Sodium | 61 | $576 |
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 |
|---|---|---|
| AbbVieCreon, Linzess | $8,310 | $229,478198 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 198 gastroenterology providers in Puerto Rico.
Other gastroenterology in Mayaguez
- Francisco CebolleroMayaguez$52K
- Omar Perez JimenezMayaguez$16K
- Priscilla Medero RodriguezMayaguez$7K
- Edward SinghMayaguez$6K
- Yue Jao AyalaMayaguez$6K
- Viviana Caban GarcesMayaguez$4K
- Felix Rivera BorgesMayaguez$3K
- Ahmed Morales JorgeCoto Laurel$214K
- Barbara Rosado CarrionPonce$176K
- Rafael Pastrana LabordeHato Rey$76K
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.