Jose Cruz Cestero, MD
Pain Medicine · Coto Laurel, PRNPI 1437158466
Payments from drug & device makers
What this record shows
The money is spread across several categories — speaking fees (56.8%), consulting fees and food and beverage — rather than concentrated in one kind of arrangement. 3 manufacturers reported payments, led by Abbott at 53.8% of the total. Reporting peaked in 2019 at $55,845 and has fallen 56.2% since, to $24,446 in 2025. Among pain 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.
Across 229 payments — averaging $855.00 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Abbott$105K
- Medtronic$86K
- Boston Scientific$5K
What the payments were for
- Consulting fees$78,66940%
- Speaking & faculty fees$111,30057%
- Food & beverage$5,8253%
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 |
|---|---|---|
| Abbott | 93 | $105,349 |
| Medtronic(2 entities) | 116 | $85,704 |
| Boston Scientific | 20 | $4,742 |
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.
- PROCLAIM$60,584
- Proclaim Family of SCS IPGs$32,108
- ADAPTIVESTIM$24,000
- Proclaim IPG$10,815
- INTELLIS$4,935
- SYNCHROMEDII$4,817
- WaveWriter Alpha Prime 16$3,025
- SYNCHROMED$2,500
- Superion Indirect Decompression System$1,214
- INTELLIS ADAPTIVESTIM$141
- ALGOLINE$128
- KYPHON Balloon Kyphoplasty$123
- ETERNA$110
- INCEPTIV$109
How this compares
$195,794 in reported general payments places this provider in the 95th 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 |
|---|---|---|
| Pregabalin | 864 | $22,793 |
| Oxycodone-AcetaminophenOxycodone Hcl/Acetaminophen | 846 | $18,610 |
| Gabapentin | 984 | $11,184 |
| Fentanyl | 68 | $8,824 |
| MovantikNaloxegol Oxalate | 18 | $7,608 |
| Acetaminophen-CodeineAcetaminophen With Codeine | 195 | $5,649 |
| Lidocaine | 31 | $5,183 |
| Baclofen | 295 | $4,005 |
| Celecoxib | 130 | $3,657 |
| Tramadol Hcl | 430 | $3,068 |
| Tizanidine Hcl | 192 | $2,498 |
| Tramadol Hcl-AcetaminophenTramadol Hcl/Acetaminophen | 103 | $1,150 |
| Oxycodone Hcl | 32 | $1,006 |
| Nabumetone | 48 | $858 |
| Carbamazepine ErCarbamazepine | 12 | $680 |
Paid to pharmacies, not to this prescriber.
Other pain medicine in Coto Laurel
- Eduardo IbarraAibonito$329K
- Carlos Buxo TiradoSan Juan$64K
- Jose Carlo IzquierdoSan Juan$49K
- Francisco Lebron-ArzonBayamon$32K
- Maria Wiscovitch GuzmanHato Rey$8K
- Jocelin Jones MolinaManati$5K
- Luis ArangurenCaguas$3K
- Francisco Irizarry RiveraPonce$2K
- Andres Melendez-DedosSan Juan$1K
- Jean Gallardo-VarelaSan Juan$1K
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.