Cristian Breton, MD
Internal Medicine · Miami, FLNPI 1881683647
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 98.1% of the total across 426 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 42 manufacturers, the largest accounting for just 11.9% — the pattern of someone who eats at a lot of different presentations. Reporting peaked in 2019 at $2,194 and has fallen 57.8% since, to $926 in 2025. Among internal medicine clinicians in FL 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 426 payments — averaging $20.32 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Lilly USA, LLC$1K
- AstraZeneca$749
- Boehringer Ingelheim$735
- AbbVie$724
- Novo Nordisk$538
- Johnson & Johnson$470
- plus $4K from 36 others
Across 839 payments — averaging $1375.56 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.
- Novartis$391K
- Novo Nordisk AS$245K
- Pfizer$196K
- AbbVie$151K
- Endo Pharmaceuticals Inc.$93K
- Janssen Research & Development, LLC$54K
- plus $24K from 1 others
What the payments were for
- Food & beverage$8,49698%
- Education$1021%
- Gifts$591%
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.
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.
- XARELTO$234
- FARXIGA$125
- ANORO ELLIPTA$122
- JARDIANCE$121
- PRALUENT$120
- BREZTRI$117
- TRELEGY ELLIPTA$115
How this compares
$8,657 in reported general payments places this provider in the 95th 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 |
|---|---|---|
| MounjaroTirzepatide | 58 | $64,787 |
| XareltoRivaroxaban | 32 | $51,486 |
| EliquisApixaban | 49 | $45,291 |
| OzempicSemaglutide | 38 | $35,768 |
| TradjentaLinagliptin | 36 | $34,548 |
| JardianceEmpagliflozin | 25 | $34,032 |
| ProliaDenosumab | 16 | $28,071 |
| MyrbetriqMirabegron | 28 | $27,766 |
| LinzessLinaclotide | 26 | $26,264 |
| Breo ElliptaFluticasone/Vilanterol | 11 | $11,435 |
| Trelegy ElliptaFluticasone/Umeclidin/Vilanter | 12 | $7,196 |
| Lantus SolostarInsulin Glargine,hum.Rec.Anlog | 31 | $5,578 |
| SynthroidLevothyroxine Sodium | 42 | $4,870 |
| Rosuvastatin Calcium | 272 | $2,060 |
| Nano 2nd Gen Pen NeedlePen Needle, Diabetic | 22 | $2,006 |
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 |
|---|---|---|
| Boehringer IngelheimTradjenta, Jardiance | $735 | $68,58161 claims |
| Lilly USA, LLCMounjaro | $1,029 | $64,78758 claims |
| Johnson & JohnsonXarelto | $470 | $51,48632 claims |
| PfizerEliquis | $361 | $45,29149 claims |
| Novo NordiskOzempic | $538 | $35,76838 claims |
| AbbVieLinzess, Synthroid | $724 | $31,13468 claims |
| AmgenProlia | $273 | $28,07116 claims |
| Astellas Pharma US IncMyrbetriq | $258 | $27,76628 claims |
| GSKBreo Ellipta, Trelegy Ellipta | $379 | $18,63123 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 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.