Ciro Ramirez, MD
Internal Medicine · Miami, FLNPI 1558547844
Payments from drug & device makers
What this record shows
This record is dominated by travel and lodging: $1,750 of the $2,387 with a category attached, or 73.3%. E.r. Squibb & Sons, L.L.C. accounts for 72.4% of it on its own, with 1 other manufacturer making up the rest.
Across 20 payments — averaging $119.36 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- E.r. Squibb & Sons, L.L.C.$2K
- Merck$659
Across 21 payments — averaging $2872.25 each. Payments tied to a research study. These frequently flow through the physician to a hospital or research institution rather than to the physician personally.
- Alnylam Pharmaceuticals Inc.$31K
- Teva Pharmaceuticals USA, Inc.$29K
What the payments were for
- Travel & lodging$1,75073%
- Food & beverage$63727%
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 |
|---|---|---|
| E.r. Squibb & Sons, L.L.C. | 14 | $1,728 |
| Merck | 6 | $659 |
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.
- LAGEVRIO$468
How this compares
$2,387 in reported general payments places this provider in the 80th percentile of 8,530 internal medicine providers in Florida.
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 |
|---|---|---|
| EliquisApixaban | 116 | $72,121 |
| OzempicSemaglutide | 50 | $55,543 |
| JardianceEmpagliflozin | 55 | $35,194 |
| EntrestoSacubitril/Valsartan | 29 | $26,358 |
| JanuviaSitagliptin Phosphate | 37 | $22,195 |
| XareltoRivaroxaban | 21 | $17,273 |
| Tresiba Flextouch U-100Insulin Degludec | 15 | $13,104 |
| JanumetSitagliptin Phos/Metformin Hcl | 19 | $9,366 |
| FarxigaDapagliflozin Propanediol | 12 | $8,042 |
| VascepaIcosapent Ethyl | 16 | $6,943 |
| LinzessLinaclotide | 11 | $5,802 |
| SymbicortBudesonide/Formoterol Fumarate | 17 | $3,390 |
| Atorvastatin Calcium | 536 | $3,083 |
| Losartan Potassium | 389 | $2,327 |
| Lantus SolostarInsulin Glargine,hum.Rec.Anlog | 15 | $1,914 |
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 |
|---|---|---|
| MerckJanuvia, Janumet | $659 | $31,56056 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 80th percentile of 8,530 internal medicine providers in Florida.
Other internal medicine in Miami
- Haytham ElgammalMiami$2.2M
- Richard AguilarMiami$239K
- Maria Delgado LelievreMiami$80K
- Marlow HernandezMiami$58K
- Steven CohnMiami$47K
- Joseph PiperatoMiami$45K
- Simon AbelsonMiami$44K
- Joel Brooks TamayoMiami$42K
- Keith RubinFort Lauderdale$2M
- Michael SensionFort Lauderdale$1M
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.