Margarita Ramirez-Vick, MD
Endocrinology, Diabetes & Metabolism · San Juan, PRNPI 1992858047
Payments from drug & device makers
What this record shows
This record is dominated by food and beverage: $13,466 of the $15,443 with a category attached, or 87.2%. It is spread thinly across 25 manufacturers, the largest accounting for just 18.4% — the pattern of someone who eats at a lot of different presentations. Reporting peaked in 2019 at $4,447 and has fallen 54.2% since, to $2,038 in 2025.
Across 419 payments — averaging $36.86 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Johnson & Johnson$3K
- Novo Nordisk$2K
- Amgen$1K
- Sanofi-aventis U.S. LLC$1K
- Boehringer Ingelheim$1K
- Bayer$1K
- plus $6K from 19 others
What the payments were for
- Consulting fees$1,87012%
- Travel & lodging$220%
- Food & beverage$13,46687%
- Education$851%
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 |
|---|---|---|
| Johnson & Johnson | 33 | $2,839 |
| Novo Nordisk | 58 | $1,789 |
| Amgen(2 entities) | 32 | $1,483 |
| Sanofi-aventis U.S. LLC | 37 | $1,267 |
| Boehringer Ingelheim | 42 | $1,153 |
| Bayer | 11 | $1,067 |
| AstraZeneca | 31 | $917 |
| Abbott | 35 | $777 |
| Lilly USA, LLC | 7 | $581 |
| Merck | 22 | $550 |
| Corcept Therapeutics | 6 | $492 |
| AbbVie | 17 | $412 |
| Dexcom, Inc. | 17 | $408 |
| PBG Puerto Rico LLC | 21 | $407 |
| Eli Lilly Export S.A. Puerto Rico Branch | 19 | $398 |
| Medtronic | 5 | $212 |
| Radius Health, Inc. | 6 | $145 |
| Bayer Puerto Rico Inc. | 8 | $142 |
| Madrigal Pharmaceuticals | 1 | $118 |
| Novartis | 5 | $105 |
| Taiho Oncology, Inc. | 1 | $62 |
| Pfizer Pharmaceuticals LLC | 2 | $47 |
| Rhythm Pharmaceuticals, Inc. | 1 | $25 |
| E.r. Squibb & Sons, L.L.C. | 1 | $25 |
| Verity Pharmaceuticals 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.
How this compares
$15,443 in reported general payments places this provider in the 80th percentile of 143 endocrinology, diabetes & metabolism providers in Puerto Rico.
See all endocrinology, diabetes & metabolism 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 |
|---|---|---|
| FarxigaDapagliflozin Propanediol | 131 | $117,613 |
| TrulicityDulaglutide | 78 | $80,410 |
| MounjaroTirzepatide | 50 | $55,328 |
| JardianceEmpagliflozin | 44 | $51,605 |
| JanumetSitagliptin Phos/Metformin Hcl | 55 | $42,390 |
| OzempicSemaglutide | 43 | $41,941 |
| KerendiaFinerenone | 32 | $30,412 |
| ProliaDenosumab | 15 | $26,517 |
| SynthroidLevothyroxine Sodium | 312 | $18,494 |
| Xigduo XrDapaglifloz Propaned/Metformin | 20 | $14,862 |
| SynjardyEmpagliflozin/Metformin Hcl | 20 | $13,397 |
| Repatha SureclickEvolocumab | 12 | $6,554 |
| LantusInsulin Glargine,hum.Rec.Anlog | 48 | $4,919 |
| HumalogInsulin Lispro | 14 | $2,314 |
| Omega-3 Acid Ethyl Esters | 21 | $2,229 |
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 |
|---|---|---|
| Lilly USA, LLCTrulicity, Mounjaro, Humalog, Humulin N | $581 | $138,702156 claims |
| AstraZenecaFarxiga | $917 | $117,613131 claims |
| Boehringer IngelheimJardiance, Synjardy | $1,153 | $65,00264 claims |
| MerckJanumet | $550 | $42,39055 claims |
| Novo NordiskOzempic | $1,789 | $41,94143 claims |
| BayerKerendia | $1,067 | $30,41232 claims |
| AmgenProlia | $1,483 | $26,51715 claims |
| AbbVieSynthroid | $412 | $18,494312 claims |
| Sanofi-aventis U.S. LLCLantus | $1,267 | $4,91948 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 143 endocrinology, diabetes & metabolism providers in Puerto Rico.
Other endocrinology, diabetes & metabolism in San Juan
- Manuel Alegre-HernandezSan Juan$156K
- Monica Ortiz-RiveraSan Juan$148K
- Alex Gonzalez BossoloSan Juan$110K
- Michelle Mangual GarciaSan Juan$87K
- Meliza Martinez RodriguezSan Juan$80K
- Jorge de Jesus MirandaSan Juan$30K
- Zahira Lugo LopezSan Juan$29K
- Oscar Ruiz BermudezSan Juan$27K
- Yanira Marrero McFalineSan Juan$14K
- Alfredo Sanchez CruzSan Juan$13K
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.