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Ismael Toro Grajales

Geriatric Medicine · Bayamon, PRNPI 1063487171

Payments from drug & device makers

What this record shows

This record is dominated by speaking fees: $3,000 of the $4,741 with a category attached, or 63.3%. Merck accounts for 70.6% of it on its own, with 4 other manufacturers making up the rest. Reporting peaked in 2022 at $3,083 and has fallen 93.5% since, to $199 in 2023. Among geriatric medicine 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.

$4,741in general payments, 2019–2025

Across 12 payments — averaging $395.07 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.

  • Merck$3K
  • AbbVie$1K
  • Johnson & Johnson$126
  • Amgen$27
  • Boehringer Ingelheim$23
$1,208,388in research payments, 2019–2025

Across 297 payments — averaging $4068.65 each. Payments tied to a research study. These frequently flow through the physician to a hospital or research institution rather than to the physician personally.

  • Merck$1.2M
  • Pfizer$15K
  • Sanofi Pasteur Inc.$15K
  • Organon$9K
  • E.r. Squibb & Sons, L.L.C.$2K

What the payments were for

  • Consulting fees$1,20025%
  • Speaking & faculty fees$3,00063%
  • Food & beverage$54111%

General payments by program year

19
20
21
22
23

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
Merck6$3,347
AbbVie2$1,218
Johnson & Johnson2$126
Amgen1$27
Boehringer Ingelheim1$23

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

$4,741 in reported general payments places this provider in the 95th percentile of 76 geriatric medicine providers in Puerto Rico.

See all geriatric medicine providers in Puerto Rico →

Most prescribed under Part D

DrugClaimsCost to plans & patients
EliquisApixaban67$34,396
JardianceEmpagliflozin33$25,744
TrulicityDulaglutide14$13,812
Trijardy XrEmpaglifloz/Linaglip/Metformin22$11,128
JentaduetoLinagliptin/Metformin Hcl13$10,009
Irbesartan-HydrochlorothiazideIrbesartan/Hydrochlorothiazide251$8,847
SynthroidLevothyroxine Sodium108$7,873
Arnuity ElliptaFluticasone Furoate37$7,843
LumiganBimatoprost27$7,367
Humulin RInsulin Regular, Human92$6,839
LantusInsulin Glargine,hum.Rec.Anlog63$6,726
Humulin NInsulin Nph Human Isophane76$6,664
FarxigaDapagliflozin Propanediol11$6,472
Rosuvastatin Calcium454$6,385
Atorvastatin Calcium523$4,366

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
Boehringer IngelheimJardiance, Trijardy Xr, Jentadueto$23$46,88268 claims
AbbVieSynthroid, Lumigan$1,218$15,240135 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 76 geriatric medicine providers in Puerto Rico.

Other geriatric medicine in Bayamon

See the full list for Puerto Rico →

Where these figures come from

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