Manuel Guzman, MD
Cardiovascular Disease · San Juan, PRNPI 1891835427
Payments from drug & device makers
What this record shows
This record is dominated by speaking fees: $194,908 of the $202,643 with a category attached, or 96.2%. Johnson & Johnson accounts for 99.3% of it on its own, with 15 other manufacturers making up the rest. Reporting peaked in 2019 at $60,298 and has fallen 99.4% since, to $350 in 2025. Among cardiovascular disease clinicians in PR 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 268 payments — averaging $756.13 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Johnson & Johnson$201K
- AstraZeneca$307
- E.r. Squibb & Sons, L.L.C.$234
- Amgen$166
- PBG Puerto Rico LLC$150
- Medtronic$134
- plus $517 from 10 others
What the payments were for
- Speaking & faculty fees$194,90896%
- Travel & lodging$8590%
- Food & beverage$6,8653%
- Education$110%
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 |
|---|---|---|
| Johnson & Johnson(2 entities) | 204 | $201,134 |
| AstraZeneca | 18 | $307 |
| E.r. Squibb & Sons, L.L.C. | 7 | $234 |
| Amgen | 8 | $166 |
| PBG Puerto Rico LLC | 8 | $150 |
| Medtronic | 1 | $134 |
| Abbott | 5 | $119 |
| Boston Scientific | 2 | $107 |
| Boehringer Ingelheim | 3 | $74 |
| Merck | 3 | $60 |
| Bayer Puerto Rico Inc. | 2 | $45 |
| Pfizer Pharmaceuticals LLC | 2 | $32 |
| ZOLL Services LLC (a/k/a ZOLL Lifecor Corp) | 2 | $25 |
| AbbVie | 1 | $25 |
| Biotronik Inc. | 1 | $24 |
| Pfizer | 1 | $6 |
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.
- XARELTO$197,867
- COREVALVE EVOLUT R$134
- CAMZYOS$119
How this compares
$202,643 in reported general payments places this provider in the 95th percentile of 267 cardiovascular disease 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 |
|---|---|---|
| EliquisApixaban | 447 | $362,968 |
| XareltoRivaroxaban | 225 | $263,761 |
| EntrestoSacubitril/Valsartan | 116 | $114,556 |
| JardianceEmpagliflozin | 72 | $70,584 |
| FarxigaDapagliflozin Propanediol | 65 | $69,617 |
| BrilintaTicagrelor | 64 | $36,715 |
| Repatha SureclickEvolocumab | 55 | $34,599 |
| Metoprolol Succinate | 1,322 | $29,375 |
| Candesartan Cilexetil | 180 | $20,852 |
| Losartan Potassium | 1,148 | $18,090 |
| Atorvastatin Calcium | 1,154 | $16,606 |
| JanuviaSitagliptin Phosphate | 11 | $16,265 |
| SynthroidLevothyroxine Sodium | 203 | $15,408 |
| Janumet XrSitagliptin Phos/Metformin Hcl | 20 | $14,833 |
| Rosuvastatin Calcium | 570 | $9,559 |
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 |
|---|---|---|
| PfizerEliquis | $6 | $362,968447 claims |
| Johnson & JohnsonXarelto | $201,134 | $263,761225 claims |
| AstraZenecaFarxiga, Brilinta | $307 | $106,332129 claims |
| Boehringer IngelheimJardiance | $74 | $70,58472 claims |
| MerckJanuvia, Janumet Xr | $60 | $31,09831 claims |
| AbbVieSynthroid | $25 | $15,408203 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 267 cardiovascular disease providers in Puerto Rico.
Other cardiovascular disease in San Juan
- Ramon PereaSan Juan$68K
- Francisco Merced-OrtizSan Juan$54K
- Sonia VicentySan Juan$23K
- Sonia Velazquez-NavarroSan Juan$17K
- Pedro Vargas-OteroSan Juan$15K
- Ricardo ColacioppoSan Juan$14K
- Jose Kareh CorderoSan Juan$13K
- William Borges CancelSan Juan$13K
- Zuanette Ramos-RoblesSan Juan$13K
- Edwin Rodriguez CruzSan Juan$12K
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.