RxDoctor Payments Data

Lionel Ramirez, MD

General Practice · Guaynabo, PRNPI 1508387200

Payments from drug & device makers

$2,033in general payments, 2019–2025

Across 97 payments — averaging $20.96 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.

  • AstraZeneca$417
  • Amgen$193
  • Bayer$185
  • Boehringer Ingelheim$167
  • Novo Nordisk$152
  • Sanofi-aventis U.S. LLC$148
  • plus $772 from 13 others

What the payments were for

  • Food & beverage$2,033100%

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

21
22
23
24
25

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.

How this compares

$2,033 in reported general payments places this provider in the 90th percentile of 3,586 general practice providers in Puerto Rico.

See all general practice providers in Puerto Rico

Medicare billing

Part B allowed, 2024
$10,916
Medicare patients
38
Services billed
138

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

DrugClaimsCost to plans & patients
JardianceEmpagliflozin89$115,931
OzempicSemaglutide47$101,336
FarxigaDapagliflozin Propanediol75$94,705
EliquisApixaban72$82,759
JanuviaSitagliptin Phosphate25$41,524
MounjaroTirzepatide17$34,600
Nurtec OdtRimegepant Sulfate21$30,264
Breztri AerosphereBudesonide/Glycopyr/Formoterol38$27,357
EntrestoSacubitril/Valsartan12$18,352
Trelegy ElliptaFluticasone/Umeclidin/Vilanter20$15,511
Soliqua 100-33Insulin Glargine/Lixisenatide15$14,946
MyrbetriqMirabegron13$13,340
TrulicityDulaglutide13$12,780
TradjentaLinagliptin11$11,501
XareltoRivaroxaban17$11,480

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.

CompanyPaid to this providerPart D cost of their drugs
Boehringer IngelheimJardiance, Tradjenta$167$127,432100 claims
AstraZenecaFarxiga, Breztri Aerosphere$417$122,063113 claims
PfizerEliquis, Nurtec Odt$51$113,02393 claims
Novo NordiskOzempic$152$101,33647 claims
Lilly USA, LLCMounjaro, Trulicity, Humulin 70-30$146$50,28952 claims
Sanofi-aventis U.S. LLCSoliqua 100-33, Lantus$148$21,18772 claims
GSKTrelegy Ellipta$117$15,51120 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 90th percentile of 3,586 general practice providers in Puerto Rico.

Other general practice in Guaynabo

See the full list for Puerto Rico

Where these figures come from

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