Ernesto Garcia-Ramos, MD
Internal Medicine · Alexandria, LANPI 1326035122
Payments from drug & device makers
Across 261 payments — averaging $16.94 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Jazz Pharmaceuticals Inc.$797
- AstraZeneca$644
- Pfizer$431
- AbbVie$328
- Novo Nordisk$327
- Abbott$282
- plus $2K from 31 others
What the payments were for
- Consulting fees$1503%
- Food & beverage$4,00491%
- Education$2666%
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 |
|---|---|---|
| Jazz Pharmaceuticals Inc. | 31 | $797 |
| AstraZeneca | 35 | $644 |
| Pfizer | 41 | $431 |
| AbbVie(2 entities) | 19 | $328 |
| Novo Nordisk | 22 | $327 |
| Abbott | 16 | $282 |
| Harmony Biosciences LLC | 10 | $171 |
| Takeda Pharmaceuticals U.S.A., Inc. | 9 | $158 |
| Lilly USA, LLC | 9 | $137 |
| Otsuka America Pharmaceutical, Inc. | 6 | $122 |
| Amgen | 7 | $113 |
| Salix Pharmaceuticals, A Division Of Bausch Health US, LLC | 7 | $101 |
| GSK | 7 | $99 |
| Dexcom, Inc. | 5 | $86 |
| Exact Sciences | 5 | $76 |
| Axsome Therapeutics, Inc. | 4 | $75 |
| Alkermes, Inc. | 3 | $62 |
| Medtronic(2 entities) | 2 | $46 |
| Acadia Pharmaceuticals Inc | 2 | $31 |
| Novartis | 2 | $31 |
| Aurinia Pharma U.S., Inc. | 2 | $29 |
| Astellas Pharma US Inc | 2 | $28 |
| Sumitomo Pharma America, Inc. | 1 | $24 |
| ITI, Inc. (d/b/a Intra-cellular Therapies, Inc.) | 1 | $24 |
| Ardelyx, Inc. | 1 | $22 |
| Kyowa Kirin, Inc. | 1 | $19 |
| Sanofi Pasteur Inc. | 1 | $17 |
| Biohaven Pharmaceutical Holding Company Ltd. | 1 | $16 |
| Boehringer Ingelheim | 1 | $16 |
| Biogen | 1 | $16 |
| Bayer | 1 | $16 |
| Melinta Therapeutics, LLC | 1 | $14 |
| Sanofi-aventis U.S. LLC | 1 | $13 |
| Eisai Inc. | 1 | $13 |
| UCB, Inc. | 1 | $12 |
| Merck | 1 | $12 |
| Paratek Pharmaceuticals, Inc. | 1 | $11 |
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
$4,420 in reported general payments places this provider in the 85th percentile of 1,528 internal medicine providers in Louisiana.
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 |
|---|---|---|
| XywavSodium,calcium,mag,pot Oxybate | 20 | $370,825 |
| Trelegy ElliptaFluticasone/Umeclidin/Vilanter | 52 | $49,138 |
| EliquisApixaban | 50 | $48,778 |
| MounjaroTirzepatide | 33 | $34,968 |
| Tresiba Flextouch U-200Insulin Degludec | 24 | $25,835 |
| OzempicSemaglutide | 22 | $23,922 |
| TrulicityDulaglutide | 19 | $22,652 |
| LinzessLinaclotide | 27 | $16,303 |
| Xigduo XrDapaglifloz Propaned/Metformin | 14 | $12,467 |
| MyrbetriqMirabegron | 20 | $11,417 |
| FarxigaDapagliflozin Propanediol | 12 | $9,924 |
| QuviviqDaridorexant Hcl | 18 | $8,806 |
| Toujeo SolostarInsulin Glargine,hum.Rec.Anlog | 15 | $6,203 |
| Lantus SolostarInsulin Glargine,hum.Rec.Anlog | 42 | $4,823 |
| FiaspInsulin Aspart (Niacinamide) | 12 | $3,413 |
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 |
|---|---|---|
| Lilly USA, LLCMounjaro, Trulicity | $137 | $57,62052 claims |
| GSKTrelegy Ellipta | $99 | $49,13852 claims |
| PfizerEliquis | $431 | $48,77850 claims |
| Novo NordiskOzempic, Fiasp | $327 | $27,33634 claims |
| AbbVieLinzess | $328 | $16,30327 claims |
| Astellas Pharma US IncMyrbetriq | $28 | $11,41720 claims |
| AstraZenecaFarxiga | $644 | $9,92412 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 85th percentile of 1,528 internal medicine providers in Louisiana.
Other internal medicine in Alexandria
- William SmithNew Orleans$50.5M
- Robert JeanfreauMetairie$13.4M
- Katherine PearceBaton Rouge$12M
- Ernest ThompsonBaker$2.1M
- Brian LewisNew Orleans$2M
- Otis BarnumNatchitoches$1.8M
- Satinder SainiCrowley$1.8M
- Randall MillerEunice$1.2M
- Donna RyanBaton Rouge$991K
- Steven DeitelzweigNew Orleans$939K
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.