Cristina Ramos, MD
Allergy & Immunology · San Juan, PRNPI 1447370523
Payments from drug & device makers
Across 875 payments — averaging $651.58 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Sanofi$178K
- Takeda Pharmaceuticals U.S.A., Inc.$126K
- Regeneron$79K
- GSK$67K
- Pfizer$24K
- Shire North American Group Inc$20K
- plus $76K from 24 others
Across 10 payments — averaging $149.57 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.
- Regeneron$1K
What the payments were for
- Consulting fees$46,92611%
- Speaking & faculty fees$343,98778%
- Travel & lodging$27,0166%
- Food & beverage$22,6995%
- Education$640%
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 |
|---|---|---|
| Sanofi | 202 | $178,227 |
| Takeda Pharmaceuticals U.S.A., Inc. | 173 | $125,661 |
| Regeneron | 129 | $79,120 |
| GSK | 64 | $66,791 |
| Pfizer | 22 | $23,921 |
| Shire North American Group Inc | 34 | $20,145 |
| Novartis | 9 | $20,144 |
| Amgen(2 entities) | 39 | $18,819 |
| AstraZeneca | 78 | $13,844 |
| Pfizer Pharmaceuticals LLC | 15 | $9,401 |
| AbbVie | 18 | $7,477 |
| Regeneron Healthcare Solutions, Inc. | 17 | $2,255 |
| Ionis Pharmaceuticals, Inc. | 2 | $1,502 |
| Biocryst US Sales Co., LLC | 12 | $439 |
| PBG Puerto Rico LLC | 25 | $415 |
| Blueprint Medicines Corporation | 3 | $271 |
| Genentech, Inc. | 6 | $263 |
| E.r. Squibb & Sons, L.L.C. | 2 | $225 |
| Genentech USA, Inc. | 5 | $216 |
| Mylan Specialty L.p. | 5 | $187 |
| Teva Pharmaceuticals USA, Inc. | 1 | $118 |
| Sanofi-aventis U.S. LLC | 3 | $113 |
| Johnson & Johnson | 2 | $108 |
| Boehringer Ingelheim | 1 | $108 |
| Bayer | 1 | $104 |
| Mallinckrodt Enterprises LLC | 1 | $100 |
| Pharming Healthcare, Inc. | 2 | $87 |
| Octapharma USA, Inc. | 2 | $34 |
| CSL Behring | 1 | $17 |
| Boston Scientific | 1 | $16 |
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.
How this compares
$570,129 in reported general payments places this provider in the 95th percentile of 25 allergy & immunology 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 |
|---|---|---|
| TakhzyroLanadelumab-Flyo | 20 | $951,592 |
| Dupixent SyringeDupilumab | 148 | $610,737 |
| Dupixent PenDupilumab | 71 | $271,442 |
| NucalaMepolizumab | 58 | $210,290 |
| FasenraBenralizumab | 26 | $149,748 |
| TezspireTezepelumab-Ekko | 24 | $96,402 |
| Trelegy ElliptaFluticasone/Umeclidin/Vilanter | 76 | $50,226 |
| XolairOmalizumab | 20 | $45,695 |
| Breo ElliptaFluticasone/Vilanterol | 60 | $24,889 |
| Spiriva RespimatTiotropium Bromide | 24 | $12,799 |
| Budesonide-Formoterol FumarateBudesonide/Formoterol Fumarate | 34 | $10,602 |
| Azelastine Hcl | 446 | $9,886 |
| Fluticasone Propionate HfaFluticasone Propionate | 30 | $9,295 |
| SymbicortBudesonide/Formoterol Fumarate | 28 | $6,462 |
| Epinephrine | 21 | $6,185 |
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 |
|---|---|---|
| Takeda Pharmaceuticals U.S.A., Inc.Takhzyro | $125,661 | $951,59220 claims |
| GSKNucala, Trelegy Ellipta, Breo Ellipta | $66,791 | $285,406194 claims |
| AstraZenecaFasenra, Tezspire, Symbicort | $13,844 | $252,61278 claims |
| Genentech, Inc.Xolair | $263 | $45,69520 claims |
| Boehringer IngelheimSpiriva Respimat | $108 | $12,79924 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 25 allergy & immunology providers in Puerto Rico.
Other allergy & immunology in San Juan
- Jose MorenoSan Juan$93K
- Yanira Benitez OrtizSan Juan$4K
- Carmen Pimentel TorresSan Juan$1K
- Janet Otero FloresSan Juan$760
- Arnaldo PerezSan Juan$334
- Carlos Lopez AlmodovarSan Juan$223
- Miriam Amaro de JesusSan Juan$118
- Jose ZaragozaSan Juan$72
- Anardi Agosto-MujicaCayey$53K
- Wilfredo Cosme BlancoAguadilla$53K
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.