David Alvarez, MD
Hand Surgery · Tallahassee, FLNPI 1104182708
Payments from drug & device makers
What this record shows
The money is spread across several categories — travel and lodging (49.7%), education and food and beverage — rather than concentrated in one kind of arrangement. 11 manufacturers reported payments, led by CGG Medical Inc at 37.6% of the total. Reporting peaked in 2019 at $3,416 and has fallen 84.1% since, to $544 in 2024.
Across 31 payments — averaging $206.74 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- CGG Medical Inc$2K
- Axogen$2K
- Anika Therapeutics, Inc.$588
- Skeletal Dynamics Inc$517
- Arthrex$262
- Exactech, Inc.$184
- plus $230 from 5 others
What the payments were for
- Travel & lodging$3,18550%
- Food & beverage$85113%
- Education$2,37337%
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 |
|---|---|---|
| CGG Medical Inc | 6 | $2,411 |
| Axogen | 8 | $2,216 |
| Anika Therapeutics, Inc. | 1 | $588 |
| Skeletal Dynamics Inc | 1 | $517 |
| Arthrex | 9 | $262 |
| Exactech, Inc. | 1 | $184 |
| Bioventus LLC | 1 | $120 |
| Smith+Nephew | 1 | $43 |
| Medline Industries LP | 1 | $27 |
| Endo Pharmaceuticals Inc. | 1 | $23 |
| Mallinckrodt Enterprises LLC | 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.
- AxoGuard Nerve Protector$2,106
- AxoGuard Nerve Connector$2,106
- WristMotion$588
- Geminus$517
- Align$517
- IJS$517
- Implate$517
- EQUINOXE$184
- Durolane$120
How this compares
$6,409 in reported general payments places this provider in the 65th percentile of 173 hand surgery 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 |
|---|---|---|
| Hydrocodone-AcetaminophenHydrocodone/Acetaminophen | 191 | $1,440 |
| Pregabalin | 15 | $689 |
| Meloxicam | 35 | $147 |
| Oxycodone-AcetaminophenOxycodone Hcl/Acetaminophen | 13 | $84 |
| Cephalexin | 22 | $28 |
| Tramadol Hcl | 18 | $28 |
Paid to pharmacies, not to this prescriber.
Other hand surgery in Tallahassee
- Jorge Orbay-CerratoMiami$12.5M
- Peter EvansStuart$525K
- Nirav GuptaOcala$491K
- Francisco RubioMiami$345K
- Justin ZumstegOrlando$133K
- Maria-Carolina Orbay AranMiami$108K
- Paul PatersonVero Beach$104K
- Helen Hui-ChouMiami$95K
- Philipp StreubelWeston$81K
- Roy CardosoCoral Gables$79K
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.