Karen Nater Pineiro
Neurology · Caguas, PRNPI 1043513302
Payments from drug & device makers
What this record shows
The money is spread across several categories — food and beverage (49.4%), consulting fees and travel and lodging — rather than concentrated in one kind of arrangement. 16 manufacturers reported payments, led by Biogen at 58.3% of the total. Reporting peaked in 2019 at $4,850 and has fallen 86.8% since, to $641 in 2025.
Across 113 payments — averaging $65.89 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Biogen$4K
- EMD Serono, Inc.$1K
- Novartis$534
- E.r. Squibb & Sons, L.L.C.$404
- Sanofi$392
- AbbVie$370
- plus $371 from 10 others
What the payments were for
- Consulting fees$3,60048%
- Travel & lodging$1562%
- Food & beverage$3,67649%
- Education$130%
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 |
|---|---|---|
| Biogen | 15 | $4,344 |
| EMD Serono, Inc. | 18 | $1,029 |
| Novartis | 22 | $534 |
| E.r. Squibb & Sons, L.L.C. | 13 | $404 |
| Sanofi | 11 | $392 |
| AbbVie | 17 | $370 |
| Genentech USA, Inc. | 4 | $106 |
| Eli Lilly Export S.A. Puerto Rico Branch | 4 | $100 |
| Amgen | 2 | $48 |
| TG Therapeutics, Inc. | 1 | $21 |
| Teva Pharmaceuticals USA, Inc. | 1 | $20 |
| AstraZeneca | 1 | $18 |
| Johnson & Johnson | 1 | $16 |
| Lilly USA, LLC | 1 | $16 |
| UCB, Inc. | 1 | $15 |
| Boston Scientific | 1 | $11 |
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
$7,445 in reported general payments places this provider in the 80th percentile of 129 neurology providers in Puerto Rico.
Most prescribed under Part D
| Drug | Claims | Cost to plans & patients |
|---|---|---|
| Austedo XrDeutetrabenazine | 18 | $87,503 |
| Nurtec OdtRimegepant Sulfate | 29 | $29,331 |
| Rivastigmine | 139 | $15,701 |
| RytaryCarbidopa/Levodopa | 12 | $10,965 |
| Aimovig AutoinjectorErenumab-Aooe | 12 | $9,135 |
| Memantine Hcl | 544 | $6,359 |
| Primidone | 145 | $5,383 |
| Carbidopa-LevodopaCarbidopa/Levodopa | 235 | $4,937 |
| Donepezil Hcl | 564 | $4,803 |
| Carbidopa-Levodopa-EntacaponeCarbidopa/Levodopa/Entacapone | 31 | $3,391 |
| Galantamine Hbr | 50 | $3,213 |
| Duloxetine Hcl | 276 | $2,989 |
| Sertraline Hcl | 452 | $2,791 |
| Pramipexole DihydrochloridePramipexole Di-Hcl | 192 | $1,825 |
| Nortriptyline Hcl | 201 | $1,794 |
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 |
|---|---|---|
| Teva Pharmaceuticals USA, Inc.Austedo Xr | $20 | $87,50318 claims |
| Lilly USA, LLCOlanzapine | $16 | $57153 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 80th percentile of 129 neurology providers in Puerto Rico.
Other neurology in Caguas
- Jose Avila OrnelasCaguas$538K
- Patricia de JesusCaguas$310K
- Luis ForastieriCaguas$6K
- Naggai Gonzalez SegarraCaguas$4K
- Daniel Reyes de JesusCaguas$3K
- Ulises NoboCaguas$2K
- Angel ChineaGuaynabo$1.7M
- Franchesca Fiorito-TorresSan Juan$453K
- Mari GarciaSan Juan$138K
- Cristina Cabret-AymatSan Juan$108K
Where these figures come from
- Payments: CMS Open Payments, program years 2019–2025 (publication P06302026_06032026).
- Identity: NPPES NPI Registry, July 2026.