Carlos Ramirez-Ramirez, MD
Infectious Disease · Santurce, PRNPI 1194793166
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 100.0% of the total across 58 separate payments, which is the pattern of a clinician who attends manufacturer presentations rather than one with a consulting arrangement. It is spread thinly across 18 manufacturers, the largest accounting for just 17.1% — the pattern of someone who eats at a lot of different presentations.
Across 58 payments — averaging $21.40 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- GSK$212
- Amgen$205
- Pfizer$149
- EMD Serono, Inc.$136
- Novartis$99
- Lilly USA, LLC$77
- plus $363 from 12 others
What the payments were for
- Food & beverage$1,241100%
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 |
|---|---|---|
| GSK | 9 | $212 |
| Amgen | 10 | $205 |
| Pfizer | 10 | $149 |
| EMD Serono, Inc. | 2 | $136 |
| Novartis | 5 | $99 |
| Lilly USA, LLC | 4 | $77 |
| AbbVie | 3 | $67 |
| Kls-martin L.p. | 2 | $66 |
| Exact Sciences | 3 | $60 |
| Paratek Pharmaceuticals, Inc. | 2 | $33 |
| Abbott | 1 | $22 |
| Novo Nordisk | 1 | $22 |
| Johnson & Johnson | 1 | $21 |
| Astellas Pharma US Inc | 1 | $17 |
| Shield Therapeutics Inc | 1 | $16 |
| Idorsia Pharmaceuticals US Inc | 1 | $14 |
| Boehringer Ingelheim | 1 | $14 |
| Viiv Healthcare Company | 1 | $12 |
How this compares
$1,241 in reported general payments places this provider in the 60th percentile of 127 infectious 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 |
|---|---|---|
| JanuviaSitagliptin Phosphate | 119 | $144,288 |
| BiktarvyBictegrav/Emtricit/Tenofov Ala | 30 | $124,385 |
| EliquisApixaban | 94 | $119,144 |
| Trelegy ElliptaFluticasone/Umeclidin/Vilanter | 78 | $114,458 |
| JardianceEmpagliflozin | 73 | $114,443 |
| OzempicSemaglutide | 47 | $67,720 |
| XareltoRivaroxaban | 35 | $34,189 |
| FarxigaDapagliflozin Propanediol | 40 | $31,907 |
| TivicayDolutegravir Sodium | 12 | $31,371 |
| DescovyEmtricitabine/Tenofov Alafenam | 12 | $30,104 |
| Breo ElliptaFluticasone/Vilanterol | 28 | $24,379 |
| MounjaroTirzepatide | 11 | $20,164 |
| Repatha SureclickEvolocumab | 24 | $15,317 |
| JanumetSitagliptin Phos/Metformin Hcl | 15 | $12,712 |
| SymbicortBudesonide/Formoterol Fumarate | 25 | $11,451 |
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 | $212 | $138,838106 claims |
| PfizerEliquis | $149 | $119,14494 claims |
| Boehringer IngelheimJardiance | $14 | $114,44373 claims |
| Novo NordiskOzempic | $22 | $67,72047 claims |
| Johnson & JohnsonXarelto | $21 | $34,18935 claims |
| Viiv Healthcare CompanyTivicay | $12 | $31,37112 claims |
| Lilly USA, LLCMounjaro | $77 | $20,16411 claims |
| AbbVieSynthroid | $67 | $3,89057 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 60th percentile of 127 infectious disease providers in Puerto Rico.
Other infectious disease in Santurce
- Marisel Bosques RosadoHato Rey$247K
- Jorge Santana BagurManati$180K
- Francisco AlvaradoCaguas$69K
- Jorge Bertran-PasarellHato Rey$64K
- Joel Munoz CoreanoBayamon$59K
- Vanessa Olivo EchavarrySan Juan$41K
- Carlos Guzman OrtizAibonito$38K
- Angeles Rodriguez RosaSan Juan$27K
- Miguel Colon PerezSan Juan$12K
- Yolanda Rodriguez-RamirezAibonito$12K
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.