Cesar Rivera, MD
Nephrology · Arecibo, PRNPI 1386749620
Payments from drug & device makers
Across 31 payments — averaging $50.59 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- AstraZeneca$409
- Lilly USA, LLC$270
- Fresenius USA Marketing, Inc.$138
- Mallinckrodt Hospital Products Inc.$137
- Mallinckrodt Enterprises LLC$99
- BD$95
- plus $421 from 10 others
What the payments were for
- Food & beverage$1,29282%
- Education$27618%
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 | 8 | $409 |
| Lilly USA, LLC | 4 | $270 |
| Fresenius USA Marketing, Inc. | 2 | $138 |
| Mallinckrodt Hospital Products Inc. | 2 | $137 |
| Mallinckrodt Enterprises LLC | 1 | $99 |
| BD | 1 | $95 |
| Novartis | 1 | $93 |
| Bayer | 1 | $77 |
| Eli Lilly Export S.A. Puerto Rico Branch | 3 | $54 |
| GSK | 1 | $45 |
| Travere Therapeutics, Inc. | 1 | $33 |
| ANI Pharmaceuticals, Inc. | 2 | $30 |
| Sanofi | 1 | $28 |
| Medtronic | 1 | $24 |
| PBG Puerto Rico LLC | 1 | $20 |
| Bayer Puerto Rico Inc. | 1 | $17 |
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.
- FARXIGA$111
How this compares
$1,568 in reported general payments places this provider in the 40th percentile of 161 nephrology 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 |
|---|---|---|
| FarxigaDapagliflozin Propanediol | 335 | $208,601 |
| KerendiaFinerenone | 102 | $69,151 |
| VelphoroSucroferric Oxyhydroxide | 24 | $56,880 |
| Lanthanum Carbonate | 67 | $43,566 |
| LokelmaSodium Zirconium Cyclosilicate | 76 | $41,598 |
| TradjentaLinagliptin | 41 | $21,983 |
| JardianceEmpagliflozin | 33 | $20,521 |
| Calcium Acetate | 191 | $14,966 |
| Sevelamer Carbonate | 112 | $13,782 |
| LantusInsulin Glargine,hum.Rec.Anlog | 79 | $7,028 |
| HumalogInsulin Lispro | 34 | $3,812 |
| SynthroidLevothyroxine Sodium | 73 | $3,233 |
| Diltiazem 24hr Er (Cd)Diltiazem Hcl | 102 | $2,054 |
| Nifedipine ErNifedipine | 84 | $1,736 |
| Humalog Mix 75-25Insulin Lispro Protamin/Lispro | 11 | $1,563 |
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 |
|---|---|---|
| AstraZenecaFarxiga, Lokelma | $409 | $250,198411 claims |
| BayerKerendia | $77 | $69,151102 claims |
| Fresenius USA Marketing, Inc.Velphoro | $138 | $56,88024 claims |
| Lilly USA, LLCHumalog, Humalog Mix 75-25, Humulin N | $270 | $5,92357 claims |
| ANI Pharmaceuticals, Inc.Valsartan | $30 | $36115 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 40th percentile of 161 nephrology providers in Puerto Rico.
Other nephrology in Arecibo
- Milton GarciaArecibo$7K
- Eddie Rodriguez CastroToa Baja$591K
- Rafael Burgos CalderonBayamon$394K
- Eugenia Galindo RamosCaguas$360K
- Jose Cangiano-RiveraSan Juan$300K
- Ileana Ocasio MelendezDorado$261K
- William Hurtado-SantiagoMayaguez$250K
- Jacobo Loyola-TorresCaguas$145K
- Ricardo Calderon OrtizCaguas$97K
- Luis QuesadaSanturce$83K
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.