Julio Bravo, MD
Rheumatology · Winston Salem, NCNPI 1598739823
Payments from drug & device makers
What this record shows
This record is dominated by speaking fees: $35,388 of the $51,571 with a category attached, or 68.6%. 30 manufacturers reported payments, led by Amgen at 47.7% of the total. Reporting peaked in 2022 at $21,085 and has fallen 76.9% since, to $4,867 in 2025. Among rheumatology clinicians in NC 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 656 payments — averaging $78.61 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Amgen$25K
- GSK$14K
- AbbVie$5K
- UCB, Inc.$2K
- Johnson & Johnson$1K
- Lilly USA, LLC$948
- plus $4K from 24 others
What the payments were for
- Consulting fees$8502%
- Speaking & faculty fees$35,38869%
- Travel & lodging$2180%
- Food & beverage$14,69929%
- Education$4161%
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(2 entities) | 134 | $24,581 |
| GSK | 26 | $14,189 |
| AbbVie | 129 | $4,650 |
| UCB, Inc. | 95 | $1,522 |
| Johnson & Johnson | 56 | $1,208 |
| Lilly USA, LLC | 40 | $948 |
| AstraZeneca(2 entities) | 34 | $850 |
| Novartis | 33 | $688 |
| Mallinckrodt Hospital Products Inc. | 14 | $463 |
| Janssen Scientific Affairs, LLC | 4 | $425 |
| Pfizer | 23 | $414 |
| Sanofi | 12 | $340 |
| Aurinia Pharma U.S., Inc. | 9 | $217 |
| Boston Scientific | 3 | $184 |
| Boehringer Ingelheim | 5 | $112 |
| Sanofi-aventis U.S. LLC | 1 | $99 |
| Radius Health, Inc. | 3 | $83 |
| E.r. Squibb & Sons, L.L.C. | 4 | $83 |
| Fresenius Kabi USA, LLC | 4 | $68 |
| Octapharma USA, Inc. | 4 | $68 |
| Sandoz | 3 | $63 |
| ANI Pharmaceuticals, Inc. | 4 | $60 |
| Genentech USA, Inc. | 3 | $59 |
| Organon | 5 | $54 |
| Grifols USA, LLC | 2 | $37 |
| Novo Nordisk | 2 | $33 |
| Vertex | 1 | $26 |
| Sobi, Inc | 1 | $18 |
| Kiniksa Pharmaceuticals International, PLC | 1 | $17 |
| Teva Pharmaceuticals USA, Inc. | 1 | $13 |
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
$51,571 in reported general payments places this provider in the 90th percentile of 210 rheumatology providers in North Carolina.
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 |
|---|---|---|
| Enbrel SureclickEtanercept | 61 | $482,640 |
| Humira(Cf) PenAdalimumab | 40 | $282,008 |
| Hydroxychloroquine Sulfate | 297 | $8,492 |
| Pilocarpine Hcl | 18 | $3,055 |
| Leflunomide | 56 | $2,484 |
| MethotrexateMethotrexate Sodium | 229 | $2,229 |
| Prednisone | 207 | $1,651 |
| Duloxetine Hcl | 31 | $684 |
| Methylprednisolone | 89 | $509 |
| Colchicine | 19 | $490 |
| Pregabalin | 14 | $367 |
| Tizanidine Hcl | 38 | $314 |
| Gabapentin | 28 | $254 |
| Folic Acid | 25 | $244 |
| Tramadol Hcl | 32 | $153 |
Paid to pharmacies, not to this prescriber.
Other rheumatology in Winston Salem
- Nilamadhab MishraWinston Salem$31K
- Elliott SembleWinston Salem$9K
- Gordon LamCharlotte$2.7M
- Ralph SnydermanDurham$1.3M
- Wendy SimmonsWilmington$462K
- Andrew LasterCharlotte$421K
- Ana RossRaleigh$417K
- Gwenesta MeltonFayetteville$410K
- Joseph ShanahanDurham$407K
- Jill ZouzoulasCharlotte$377K
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.