Julio Peguero, MD
Internal Medicine · Houston, TXNPI 1659569507
Payments from drug & device makers
What this record shows
This record is dominated by food and beverage: $21,105 of the $26,849 with a category attached, or 78.6%. It is spread thinly across 60 manufacturers, the largest accounting for just 12.9% — the pattern of someone who eats at a lot of different presentations. Among internal medicine clinicians in TX 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 1,095 payments — averaging $24.52 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Novartis$3K
- Tersera Therapeutics LLC$3K
- E.r. Squibb & Sons, L.L.C.$2K
- Johnson & Johnson$2K
- Pfizer$2K
- Bristol Myers Squibb$1K
- plus $14K from 54 others
Across 839 payments — averaging $8327.59 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$1.9M
- Mirati Therapeutics, Inc.$819K
- Janssen Research & Development, LLC$654K
- EMD Serono, Inc.$413K
- Eli Lilly$378K
- Amgen$312K
- plus $2.5M from 29 others
What the payments were for
- Consulting fees$2,4759%
- Grants$2351%
- Travel & lodging$7163%
- Food & beverage$21,10579%
- Education$7233%
- Gifts$1,5956%
Most of this is food and beverage — typically meals provided during product presentations at a clinic or hospital. Nationally that is the single largest category of reported payments by count.
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.
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
$26,849 in reported general payments places this provider in the 95th percentile of 7,675 internal medicine providers in Texas.
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 |
|---|---|---|
| ErleadaApalutamide | 60 | $809,696 |
| RevlimidLenalidomide | 22 | $532,573 |
| TagrissoOsimertinib Mesylate | 27 | $463,257 |
| PromactaEltrombopag Olamine | 30 | $426,789 |
| VerzenioAbemaciclib | 27 | $371,411 |
| BrukinsaZanubrutinib | 17 | $231,540 |
| TavalisseFostamatinib Disodium | 11 | $163,932 |
| BesremiRopeginterferon Alfa-2b-Njft | 17 | $147,836 |
| Abiraterone Acetate | 34 | $95,783 |
| NeulastaPegfilgrastim | 15 | $92,935 |
| EliquisApixaban | 53 | $54,081 |
| Exemestane | 176 | $32,586 |
| Fondaparinux Sodium | 14 | $32,313 |
| AranespDarbepoetin Alfa In Polysorbat | 14 | $31,041 |
| Granisetron Hcl | 57 | $17,313 |
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 |
|---|---|---|
| Johnson & JohnsonErleada | $1,762 | $809,69660 claims |
| Bristol Myers SquibbRevlimid | $1,085 | $532,57322 claims |
| AstraZenecaTagrisso | $347 | $463,25727 claims |
| NovartisPromacta | $3,462 | $426,78930 claims |
| Lilly USA, LLCVerzenio | $162 | $371,41127 claims |
| Beigene USA, Inc.Brukinsa | $413 | $231,54017 claims |
| Pharmaessentia USA CorporationBesremi | $230 | $147,83617 claims |
| AmgenNeulasta, Aranesp | $912 | $123,97629 claims |
| PfizerEliquis | $1,517 | $54,08153 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 7,675 internal medicine providers in Texas.
Other internal medicine in Houston
- Hussein TawbiHouston$365K
- Hans LeeHouston$327K
- Tapan KadiaHouston$311K
- Nitin JainHouston$281K
- Krina PatelHouston$255K
- Nicholas ShortHouston$247K
- Naveen PemmarajuHouston$230K
- Mariana Chavez MacgregorHouston$188K
- Shumei KatoHouston$180K
- Sukhdeep BasraHouston$168K
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.