Francisco Alvarado, MD
Infectious Disease · Caguas, PRNPI 1437199593
Payments from drug & device makers
What this record shows
This record is dominated by speaking fees: $62,080 of the $68,613 with a category attached, or 90.5%. Merck accounts for 68.0% of it on its own, with 7 other manufacturers making up the rest. 2025 is the largest year on record at $26,666, 2.2 times the $12,267 reported in 2019. Among infectious disease clinicians in PR with any reported payments, this total sits in the top 5% — high for the specialty, which is a reason to read the composition above rather than the number alone.
Across 100 payments — averaging $686.13 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Merck$47K
- AbbVie$21K
- ZOLL Services LLC (a/k/a ZOLL Lifecor Corp)$251
- Verity Pharmaceuticals Inc.$123
- E.r. Squibb & Sons, L.L.C.$112
- Johnson & Johnson$107
- plus $120 from 2 others
What the payments were for
- Consulting fees$3,4005%
- Speaking & faculty fees$62,08090%
- Travel & lodging$4631%
- Food & beverage$2,6714%
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 |
|---|---|---|
| Merck | 57 | $46,678 |
| AbbVie(2 entities) | 33 | $21,221 |
| ZOLL Services LLC (a/k/a ZOLL Lifecor Corp) | 4 | $251 |
| Verity Pharmaceuticals Inc. | 1 | $123 |
| E.r. Squibb & Sons, L.L.C. | 1 | $112 |
| Johnson & Johnson | 2 | $107 |
| Gilead | 1 | $100 |
| PBG Puerto Rico LLC | 1 | $20 |
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
$68,613 in reported general payments places this provider in the 95th percentile of 127 infectious disease 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 |
|---|---|---|
| MavyretGlecaprevir/Pibrentasvir | 11 | $143,555 |
| GenvoyaElviteg/Cob/Emtri/Tenof Alafen | 28 | $109,686 |
| JulucaDolutegravir/Rilpivirine | 14 | $48,678 |
| Acyclovir | 12 | $330 |
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 |
|---|---|---|
| AbbVieMavyret | $21,221 | $143,55511 claims |
| GileadGenvoya | $100 | $109,68628 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 95th percentile of 127 infectious disease providers in Puerto Rico.
Other infectious disease in Caguas
- Hector Melendez-GonzalezCaguas$4K
- Diana Otero-CastroCaguas$1K
- Eileen Colon SantosCaguas$822
- Marisel Bosques RosadoHato Rey$247K
- Jorge Santana BagurManati$180K
- Jorge Bertran-PasarellHato Rey$64K
- Joel Munoz CoreanoBayamon$59K
- Vanessa Olivo EchavarrySan Juan$41K
- Carlos Guzman OrtizAibonito$38K
- Angeles Rodriguez RosaSan Juan$27K
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.