Miguel Gonzalez, APRN
Clinical Nurse Specialist · Fort Myers, FLNPI 1962928994
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 100.0% of the total across 13 separate payments, which is the pattern of a clinician who attends manufacturer presentations rather than one with a consulting arrangement. Amgen accounts for 72.0% of it on its own, with 4 other manufacturers making up the rest. 2025 is the largest year on record at $321, more than ten times the $13 reported in 2022.
Across 13 payments — averaging $29.28 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Amgen$274
- Exact Sciences$47
- Novartis$22
- Novo Nordisk$21
- Merck$16
What the payments were for
- Food & beverage$381100%
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 |
|---|---|---|
| Amgen | 8 | $274 |
| Exact Sciences | 2 | $47 |
| Novartis | 1 | $22 |
| Novo Nordisk | 1 | $21 |
| Merck | 1 | $16 |
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.
- Repatha$121
How this compares
Too few clinical nurse specialist providers in Floridato place this figure against a meaningful peer group, so we don't.
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 | 60 | $17,641 |
| SpsSodium Polystyrene Sulfon/Sorb | 14 | $3,627 |
| Levothyroxine Sodium | 226 | $1,908 |
| Mirtazapine | 73 | $1,071 |
| Metoprolol Succinate | 86 | $1,048 |
| Warfarin Sodium | 145 | $900 |
| Atorvastatin Calcium | 112 | $750 |
| Gabapentin | 68 | $653 |
| Fluticasone Propionate | 36 | $652 |
| Amlodipine Besylate | 91 | $635 |
| Furosemide | 117 | $579 |
| Buspirone Hcl | 16 | $470 |
| Lantus SolostarInsulin Glargine,hum.Rec.Anlog | 16 | $467 |
| Losartan Potassium | 64 | $460 |
| Methenamine Hippurate | 30 | $456 |
Paid to pharmacies, not to this prescriber.
Other clinical nurse specialist in Fort Myers
- Tammy McCartyFort Myers$1K
- Roberta MarinoFort Myers$1K
- Stacy O'BrienFort Myers$285
- Robin GaspariniFernandina Beach$64K
- Patricia GeddieOrlando$3K
- Clarissa WelbaumOrlando$1K
- Allison TuppenyOrlando$393
- Dana GreggsOrlando$309
- Suzanne AshworthOrlando$179
- Mary SendinOrlando$165
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.