Elena Iguina Gonzalez, MD
Foot and Ankle Surgery · Cayey, PRNPI 1780099952
Payments from drug & device makers
What this record shows
This record is dominated by grants: $10,832 of the $18,043 with a category attached, or 60.0%. Arthrex accounts for 80.3% of it on its own, with 7 other manufacturers making up the rest. Reporting peaked in 2021 at $13,053 and has fallen 91.3% since, to $1,138 in 2023.
Across 48 payments — averaging $375.89 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Arthrex$14K
- Mid-atlantic Surgical Systems, LLC$2K
- Stryker$599
- Medical Device Business Services, Inc.$330
- Smith+Nephew$103
- Acumed LLC$94
- plus $29 from 2 others
What the payments were for
- Grants$10,83260%
- Travel & lodging$1,3467%
- Food & beverage$7344%
- Education$5,13028%
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 |
|---|---|---|
| Arthrex | 29 | $14,482 |
| Mid-atlantic Surgical Systems, LLC | 3 | $2,406 |
| Stryker | 10 | $599 |
| Medical Device Business Services, Inc. | 1 | $330 |
| Smith+Nephew | 1 | $103 |
| Acumed LLC | 2 | $94 |
| Encore Medical, LP | 1 | $17 |
| Johnson And Johnson International | 1 | $12 |
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
Too few foot and ankle surgery providers in Puerto Ricoto place this figure against a meaningful peer group, so we don't.
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 |
|---|---|---|
| Methylprednisolone | 44 | $430 |
| Gabapentin | 67 | $391 |
| Meloxicam | 69 | $330 |
| Amoxicillin-Clavulanate PotassAmoxicillin/Potassium Clav | 15 | $273 |
| Oxycodone-AcetaminophenOxycodone Hcl/Acetaminophen | 27 | $251 |
| Cephalexin | 29 | $93 |
Paid to pharmacies, not to this prescriber.
Other foot and ankle surgery in Cayey
- Gilberto Vila ArroyoSan Juan$11K
- Vincent WalshGuaynabo$4K
- Jose MatteiArecibo$4K
- Luis Esquerdo CruzSan Juan$2K
- Jose Perez-MaldonadoSan Juan$2K
- Jose AponteCaguas$2K
- Silfredo SilvestriniPonce$2K
- Fernando Pinero CadizHumacao$313
- Efrain Castro IrizarrySan German$150
- Carlos FragaBayamon$144
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.