RxDoctor Payments Data

Ernesto Carames, MD

Internal Medicine · St Augustine, FLNPI 1528099603

Payments from drug & device makers

$9,391in general payments, 2019–2025

Across 763 payments — averaging $12.31 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.

  • Novo Nordisk$1K
  • AstraZeneca$900
  • Boehringer Ingelheim$823
  • Amgen$691
  • Astellas Pharma US Inc$599
  • GSK$480
  • plus $4K from 53 others

What the payments were for

  • Food & beverage$9,28399%
  • Education$1081%

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

19
20
21
22
23
24
25

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.

CompanyPaymentsTotal
Novo Nordisk341$1,488
AstraZeneca46$900
Boehringer Ingelheim51$823
Amgen(2 entities)37$691
Astellas Pharma US Inc32$599
GSK31$480
Merck24$437
Lilly USA, LLC24$429
Pfizer18$307
Sanofi-aventis U.S. LLC13$246
Abbott11$201
Eisai Inc.7$176
Bayer5$158
Amarin Pharma, Inc.9$157
Corcept Therapeutics7$146
Angiodynamics, Inc.7$144
Exact Sciences9$144
Daiichi Sankyo Inc.8$142
Johnson & Johnson8$133
Medtronic1$129
Insmed, Inc.5$118
Shield Therapeutics Inc1$103
Salix Pharmaceuticals, A Division Of Bausch Health US, LLC7$103
Inspire Medical Systems, Inc.3$82
Esperion Therapeutics, Inc.4$78
Otsuka America Pharmaceutical, Inc.3$73
AbbVie4$70
Sumitomo Pharma America, Inc.3$64
Radius Health, Inc.3$60
Ultragenyx Pharmaceutical Inc.3$59
E.r. Squibb & Sons, L.L.C.3$53
Sunovion Pharmaceuticals Inc.2$41
Kowa Pharmaceuticals America, Inc.3$35
Idorsia Pharmaceuticals US Inc2$35
Hikma Pharmaceuticals USA2$33
Vifor Pharma, Inc.2$32
Almatica Pharma LLC2$31
C2n Diagnostics, LLC1$30
Alnylam Pharmaceuticals Inc.1$27
Irhythm Technologies, Inc.1$24
Chiesi USA, Inc.1$22
Smith+Nephew1$21
Philips North America LLC1$20
Sanofi1$20
Mylan Specialty L.p.1$18
Renalytix AI, Inc.1$18
Bausch Health US, LLC1$16
Mallinckrodt Enterprises LLC1$16
Ironwood Pharmaceuticals, Inc1$16
Insulet Corporation1$15
Takeda Pharmaceuticals U.S.A., Inc.1$15
Pulmonx Corporation1$15
Paratek Pharmaceuticals, Inc.1$15
Eyevance Pharmaceuticals LLC1$14
Aegerion Pharmaceuticals, Inc.1$14
Sanofi Pasteur Inc.1$14
Sun Pharmaceutical Industries Inc.1$13
Ferring Pharmaceuticals Inc.1$13
Venclose Inc.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

$9,391 in reported general payments places this provider in the 90th percentile of 8,530 internal medicine providers in Florida.

See all internal medicine providers in Florida

Medicare billing

Part B allowed, 2024
$332,406
Medicare patients
530
Services billed
3,966

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

DrugClaimsCost to plans & patients
EliquisApixaban183$169,651
OzempicSemaglutide121$169,107
RybelsusSemaglutide83$139,029
FarxigaDapagliflozin Propanediol128$118,669
MounjaroTirzepatide90$100,024
MyrbetriqMirabegron96$89,394
JardianceEmpagliflozin71$82,059
XareltoRivaroxaban61$64,454
LinzessLinaclotide85$54,566
TradjentaLinagliptin33$34,978
JanuviaSitagliptin Phosphate31$34,534
Trelegy ElliptaFluticasone/Umeclidin/Vilanter41$27,044
EntrestoSacubitril/Valsartan31$26,545
Repatha SureclickEvolocumab24$26,273
Bydureon BciseExenatide Microspheres23$22,831

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.

CompanyPaid to this providerPart D cost of their drugs
Novo NordiskOzempic, Rybelsus$1,488$308,136204 claims
PfizerEliquis$307$169,651183 claims
AstraZenecaFarxiga, Symbicort$900$129,580159 claims
Boehringer IngelheimJardiance, Tradjenta, Stiolto Respimat$823$126,349121 claims
Lilly USA, LLCMounjaro, Trulicity$429$110,941101 claims
Astellas Pharma US IncMyrbetriq$599$89,39496 claims
Johnson & JohnsonXarelto$133$64,45461 claims
AbbVieLinzess$70$54,56685 claims
GSKTrelegy Ellipta, Breo Ellipta$480$45,67863 claims
MerckJanuvia$437$34,53431 claims
Otsuka America Pharmaceutical, Inc.Rexulti$73$22,72116 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 8,530 internal medicine providers in Florida.

Other internal medicine in St Augustine

See the full list for Florida

Where these figures come from

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