Ernesto Marrero de Gracia, MD
Internal Medicine · Bayamon, PRNPI 1295743367
Payments from drug & device makers
Across 82 payments — averaging $27.46 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- AstraZeneca$519
- Johnson & Johnson$422
- PBG Puerto Rico LLC$276
- E.r. Squibb & Sons, L.L.C.$267
- Boehringer Ingelheim$247
- Eli Lilly Export S.A. Puerto Rico Branch$109
- plus $412 from 8 others
What the payments were for
- Food & beverage$2,18897%
- Education$643%
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 | 20 | $519 |
| Johnson & Johnson | 15 | $422 |
| PBG Puerto Rico LLC | 12 | $276 |
| E.r. Squibb & Sons, L.L.C. | 5 | $267 |
| Boehringer Ingelheim | 7 | $247 |
| Eli Lilly Export S.A. Puerto Rico Branch | 6 | $109 |
| GSK | 4 | $102 |
| Lilly USA, LLC | 3 | $100 |
| Merck | 4 | $81 |
| Biohaven Pharmaceuticals, Inc. | 2 | $47 |
| Novartis | 1 | $24 |
| Pfizer | 1 | $23 |
| Novo Nordisk | 1 | $20 |
| Amneal Pharmaceuticals 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.
How this compares
$2,252 in reported general payments places this provider in the 80th percentile of 1,043 internal medicine 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 |
|---|---|---|
| EliquisApixaban | 138 | $122,986 |
| JardianceEmpagliflozin | 107 | $121,299 |
| FarxigaDapagliflozin Propanediol | 105 | $110,687 |
| JanuviaSitagliptin Phosphate | 54 | $70,884 |
| XareltoRivaroxaban | 54 | $60,855 |
| JanumetSitagliptin Phos/Metformin Hcl | 47 | $51,972 |
| TrulicityDulaglutide | 37 | $49,079 |
| MounjaroTirzepatide | 24 | $36,680 |
| OzempicSemaglutide | 33 | $35,044 |
| SynthroidLevothyroxine Sodium | 296 | $32,639 |
| EntrestoSacubitril/Valsartan | 29 | $22,137 |
| LantusInsulin Glargine,hum.Rec.Anlog | 191 | $18,259 |
| Janumet XrSitagliptin Phos/Metformin Hcl | 12 | $16,142 |
| Trijardy XrEmpaglifloz/Linaglip/Metformin | 15 | $16,105 |
| JentaduetoLinagliptin/Metformin Hcl | 16 | $14,369 |
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 |
|---|---|---|
| Boehringer IngelheimJardiance, Trijardy Xr, Jentadueto, Glyxambi, Tradjenta | $247 | $175,271164 claims |
| MerckJanuvia, Janumet, Janumet Xr | $81 | $138,997113 claims |
| PfizerEliquis | $23 | $122,986138 claims |
| AstraZenecaFarxiga, Symbicort | $519 | $114,967123 claims |
| Lilly USA, LLCTrulicity, Mounjaro, Humalog, Humulin 70-30 | $100 | $98,422174 claims |
| Johnson & JohnsonXarelto | $422 | $60,85554 claims |
| Novo NordiskOzempic | $20 | $35,04433 claims |
| NovartisEntresto | $24 | $22,13729 claims |
| GSKBreo Ellipta | $102 | $12,34530 claims |
| Amneal Pharmaceuticals LLCLevothyroxine Sodium | $16 | $6,649389 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 80th percentile of 1,043 internal medicine providers in Puerto Rico.
Other internal medicine in Bayamon
- Sixto MedinaBayamon$15K
- Graciela Latalladi OrtegaBayamon$11K
- Pedro Roman EyxarchBayamon$9K
- Neisa Torres ReyesBayamon$8K
- Luis FortiBayamon$8K
- Carlos AcostaBayamon$7K
- Jose Aviles MunozBayamon$6K
- Steven CruzBayamon$6K
- Lionel Velez MontijoBayamon$6K
- Wanda Beltran VirellaBayamon$5K
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.