Jose Carlo Izquierdo, MD
Pain Medicine · San Juan, PRNPI 1710023668
Payments from drug & device makers
What this record shows
This record is dominated by speaking fees: $31,419 of the $49,153 with a category attached, or 63.9%. 23 manufacturers reported payments, led by Amgen at 41.8% of the total. 2025 is the largest year on record at $37,194, more than ten times the $2,332 reported in 2019. Among pain medicine clinicians in PR with any reported payments, this total sits in the top 10% — high for the specialty, which is a reason to read the composition above rather than the number alone.
Across 143 payments — averaging $343.73 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Amgen$21K
- Argenx US, Inc.$16K
- Sanofi$10K
- AstraZeneca$697
- Biogen$681
- Novartis$238
- plus $1K from 17 others
What the payments were for
- Consulting fees$8,40317%
- Speaking & faculty fees$31,41964%
- Travel & lodging$4,97710%
- Food & beverage$4,2139%
- Education$1420%
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 |
|---|---|---|
| Amgen | 19 | $20,535 |
| Argenx US, Inc. | 18 | $16,221 |
| Sanofi | 11 | $9,696 |
| AstraZeneca | 20 | $697 |
| Biogen | 26 | $681 |
| Novartis | 11 | $238 |
| Tanabe Pharma America, Inc. | 4 | $216 |
| Genentech USA, Inc. | 7 | $150 |
| Akcea Therapeutics, Inc. | 2 | $129 |
| E.r. Squibb & Sons, L.L.C. | 5 | $97 |
| UCB, Inc. | 3 | $82 |
| AbbVie | 3 | $74 |
| Eli Lilly Export S.A. Puerto Rico Branch | 3 | $61 |
| EMD Serono, Inc. | 1 | $47 |
| PTC Therapeutics, Inc. | 1 | $38 |
| Johnson & Johnson | 2 | $37 |
| Eisai Inc. | 1 | $27 |
| Alnylam Pharmaceuticals Inc. | 1 | $26 |
| Teva Pharmaceuticals USA, Inc. | 1 | $24 |
| Banner Life Sciences, LLC | 1 | $21 |
| Acorda Therapeutics, Inc | 1 | $20 |
| CSL Behring | 1 | $20 |
| Pfizer Pharmaceuticals LLC | 1 | $18 |
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.
- VYVGART$14,062
- UPLIZNA$9,164
- DISEASE STATE$1,803
- SOLIRIS$125
- VYVGART HYTRULO$118
- TEGSEDI$114
- Vumerity$113
How this compares
$49,153 in reported general payments places this provider in the 90th percentile of 46 pain 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 |
|---|---|---|
| Radicava OrsEdaravone | 15 | $212,128 |
| Pyridostigmine Bromide | 44 | $3,993 |
| Gabapentin | 169 | $3,035 |
| Carbidopa-Levodopa ErCarbidopa/Levodopa | 13 | $3,034 |
| Rivastigmine | 14 | $1,984 |
| SynthroidLevothyroxine Sodium | 18 | $1,158 |
| Carbidopa-LevodopaCarbidopa/Levodopa | 26 | $900 |
| Pregabalin | 62 | $744 |
| ValacyclovirValacyclovir Hcl | 11 | $623 |
| Donepezil Hcl | 54 | $610 |
| Memantine Hcl | 20 | $552 |
| Prednisone | 56 | $467 |
| Quetiapine Fumarate | 35 | $427 |
| Clonazepam | 36 | $400 |
| Oxcarbazepine | 22 | $382 |
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 |
|---|---|---|
| AbbVieSynthroid | $74 | $1,15818 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 46 pain medicine providers in Puerto Rico.
Other pain medicine in San Juan
- Carlos Buxo TiradoSan Juan$64K
- Andres Melendez-DedosSan Juan$1K
- Jean Gallardo-VarelaSan Juan$1K
- Richard Fontanez NievesSan Juan$972
- Jorge CaceresSan Juan$644
- Veronica Key OyolaSan Juan$478
- Luis OlmedoSan Juan$127
- Aurea Negron ValcarcelSan Juan$117
- Amneris Lugo RiveraSan Juan$109
- Jose Oller LopezSan Juan$94
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.