Elvia Ayala Hernandez, MD
General Practice · Aguadilla, PRNPI 1497881189
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 100.0% of the total across 74 separate payments, which is the pattern of a clinician who attends manufacturer presentations rather than one with a consulting arrangement. AstraZeneca accounts for 75.1% of it on its own, with 6 other manufacturers making up the rest. Among general practice clinicians in PR with any reported payments, this total sits in the top 10% — high for the specialty, which is a reason to read the composition above rather than the number alone.
Across 74 payments — averaging $21.39 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- AstraZeneca$1K
- Sanofi-aventis U.S. LLC$157
- Eli Lilly Export S.A. Puerto Rico Branch$73
- Lilly USA, LLC$55
- Boehringer Ingelheim$49
- GSK$39
- plus $20 from 1 others
What the payments were for
- Food & beverage$1,583100%
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.
| Company | Payments | Total |
|---|---|---|
| AstraZeneca | 54 | $1,188 |
| Sanofi-aventis U.S. LLC | 8 | $157 |
| Eli Lilly Export S.A. Puerto Rico Branch | 4 | $73 |
| Lilly USA, LLC | 2 | $55 |
| Boehringer Ingelheim | 2 | $49 |
| GSK | 3 | $39 |
| PBG Puerto Rico LLC | 1 | $20 |
How this compares
$1,583 in reported general payments places this provider in the 90th percentile of 3,586 general practice 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 |
|---|---|---|
| FarxigaDapagliflozin Propanediol | 106 | $118,286 |
| Xigduo XrDapaglifloz Propaned/Metformin | 34 | $35,915 |
| JardianceEmpagliflozin | 29 | $29,468 |
| XareltoRivaroxaban | 27 | $27,557 |
| Soliqua 100-33Insulin Glargine/Lixisenatide | 25 | $24,211 |
| SynthroidLevothyroxine Sodium | 237 | $22,472 |
| EliquisApixaban | 19 | $19,546 |
| TrulicityDulaglutide | 18 | $17,693 |
| JanuviaSitagliptin Phosphate | 22 | $16,045 |
| Budesonide-Formoterol FumarateBudesonide/Formoterol Fumarate | 54 | $15,923 |
| DiovanValsartan | 24 | $12,376 |
| Trelegy ElliptaFluticasone/Umeclidin/Vilanter | 14 | $9,312 |
| Breztri AerosphereBudesonide/Glycopyr/Formoterol | 12 | $9,055 |
| Spiriva RespimatTiotropium Bromide | 11 | $8,908 |
| BrilintaTicagrelor | 15 | $8,547 |
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 |
|---|---|---|
| AstraZenecaFarxiga, Breztri Aerosphere, Brilinta | $1,188 | $135,888133 claims |
| Boehringer IngelheimJardiance, Spiriva Respimat | $49 | $38,37740 claims |
| Sanofi-aventis U.S. LLCSoliqua 100-33, Lantus | $157 | $27,80651 claims |
| Lilly USA, LLCTrulicity | $55 | $17,69318 claims |
| GSKTrelegy Ellipta | $39 | $9,31214 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 90th percentile of 3,586 general practice providers in Puerto Rico.
Other general practice in Aguadilla
- Carlos Abreu GiraldAguadilla$15K
- Wilfredo CuevasSan Lorenzo$530K
- Julio BacoMayaguez$268K
- Soria Diaz BaezPonce$192K
- Carlos RomanCanovanas$140K
- William E TorresSan Juan$86K
- Rafael Mendoza RodriguezPonce$77K
- Frank Perez NogueiraSan German$70K
- Vivian Tamayo AgraitSan Juan$64K
- William Soto AvilesToa Baja$63K
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.