Kelvin Rivera Manzano, MD
Critical Care Medicine · Caguas, PRNPI 1619226578
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 92.8% of the total across 19 separate payments, which is the pattern of a clinician who attends manufacturer presentations rather than one with a consulting arrangement. 11 manufacturers reported payments, led by GSK at 45.3% of the total. Reporting peaked in 2019 at $680 and has fallen 89.4% since, to $72 in 2024. That places this record below the midpoint for critical care medicine clinicians in PR, where the typical reported total is $1,029.
Across 19 payments — averaging $43.94 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- GSK$378
- Genentech USA, Inc.$125
- Medtronic$72
- Chiesi USA, Inc.$60
- Boehringer Ingelheim$45
- AstraZeneca$43
- plus $111 from 5 others
What the payments were for
- Food & beverage$77593%
- Gifts$607%
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.
| Company | Payments | Total |
|---|---|---|
| GSK | 6 | $378 |
| Genentech USA, Inc. | 1 | $125 |
| Medtronic | 1 | $72 |
| Chiesi USA, Inc. | 1 | $60 |
| Boehringer Ingelheim | 2 | $45 |
| AstraZeneca | 3 | $43 |
| Sanofi-aventis U.S. LLC | 1 | $25 |
| United Therapeutics Corporation | 1 | $23 |
| Grifols USA, LLC | 1 | $23 |
| Sanofi | 1 | $20 |
| Shire North American Group Inc | 1 | $20 |
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.
- TRELEGY ELLIPTA$240
- Esbriet$125
- NUCALA$100
How this compares
$835 in reported general payments places this provider in the 40th percentile of 21 critical care 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 |
|---|---|---|
| Wixela InhubFluticasone Propion/Salmeterol | 38 | $5,012 |
| Albuterol Sulfate HfaAlbuterol Sulfate | 26 | $1,152 |
| Clonazepam | 14 | $188 |
| Fluticasone Propionate | 15 | $187 |
| Montelukast Sodium | 11 | $76 |
Paid to pharmacies, not to this prescriber.
Other critical care medicine in Caguas
- Axia Dones RodriguezCaguas$2K
- Enrique Rodriguez AvilaCaguas$405
- Christian Castillo LatorreSan Juan$35K
- Carlos Garcia RodriguezSan Juan$10K
- Gloria Rodriguez VegaBayamon$10K
- Daniel Font RiveraSan Juan$7K
- Jaime Aponte RodriguezSan Juan$2K
- Yomayra Otero-DominguezSan Juan$2K
- Adriana ArcilaManati$2K
- Ramon Paoli BrunoHumacao$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.