Milliette Alvarado Santiago, MD
Endocrinology, Diabetes & Metabolism · Rio Piedras, PRNPI 1821306127
Payments from drug & device makers
What this record shows
This record is dominated by speaking fees: $58,390 of the $75,194 with a category attached, or 77.7%. Lilly USA, LLC accounts for 74.3% of it on its own, with 21 other manufacturers making up the rest. Among endocrinology, diabetes & metabolism 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 328 payments — averaging $229.25 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Lilly USA, LLC$56K
- Rhythm Pharmaceuticals, Inc.$8K
- Eli Lilly Export S.A. Puerto Rico Branch$4K
- Johnson & Johnson$3K
- Boehringer Ingelheim$692
- Novo Nordisk$636
- plus $3K from 16 others
What the payments were for
- Consulting fees$1,8702%
- Speaking & faculty fees$58,39078%
- Travel & lodging$6,8829%
- Food & beverage$8,04711%
- Education$50%
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 |
|---|---|---|
| Lilly USA, LLC | 93 | $55,897 |
| Rhythm Pharmaceuticals, Inc. | 9 | $7,710 |
| Eli Lilly Export S.A. Puerto Rico Branch | 23 | $4,383 |
| Johnson & Johnson | 21 | $2,592 |
| Boehringer Ingelheim | 25 | $692 |
| Novo Nordisk | 27 | $636 |
| Merck | 17 | $472 |
| Sanofi-aventis U.S. LLC | 20 | $429 |
| AstraZeneca | 15 | $423 |
| Abbott | 23 | $422 |
| Amgen | 12 | $404 |
| Dexcom, Inc. | 10 | $280 |
| PBG Puerto Rico LLC | 11 | $219 |
| Corcept Therapeutics | 2 | $149 |
| AbbVie | 7 | $145 |
| Radius Health, Inc. | 3 | $71 |
| Bayer Puerto Rico Inc. | 3 | $63 |
| Taiho Oncology, Inc. | 1 | $62 |
| Medtronic | 2 | $56 |
| Pfizer Pharmaceuticals LLC | 2 | $47 |
| Novartis | 1 | $21 |
| 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
$75,194 in reported general payments places this provider in the 95th 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 |
|---|---|---|
| OzempicSemaglutide | 183 | $183,025 |
| TrulicityDulaglutide | 132 | $139,687 |
| MounjaroTirzepatide | 90 | $101,481 |
| JardianceEmpagliflozin | 60 | $55,622 |
| Janumet XrSitagliptin Phos/Metformin Hcl | 88 | $55,244 |
| Synjardy XrEmpagliflozin/Metformin Hcl | 81 | $53,454 |
| Jentadueto XrLinagliptin/Metformin Hcl | 78 | $46,893 |
| ProliaDenosumab | 26 | $45,675 |
| Xigduo XrDapaglifloz Propaned/Metformin | 53 | $36,267 |
| FarxigaDapagliflozin Propanediol | 48 | $35,085 |
| SynthroidLevothyroxine Sodium | 687 | $32,964 |
| Trijardy XrEmpaglifloz/Linaglip/Metformin | 41 | $27,667 |
| GlyxambiEmpagliflozin/Linagliptin | 26 | $17,330 |
| TradjentaLinagliptin | 27 | $16,433 |
| LantusInsulin Glargine,hum.Rec.Anlog | 137 | $9,749 |
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 70-30 | $55,897 | $251,255339 claims |
| Boehringer IngelheimJardiance, Synjardy Xr, Jentadueto Xr, Trijardy Xr, Glyxambi | $692 | $217,399313 claims |
| Novo NordiskOzempic | $636 | $183,025183 claims |
| MerckJanumet Xr | $472 | $55,24488 claims |
| AmgenProlia | $404 | $45,67526 claims |
| AstraZenecaFarxiga | $423 | $35,08548 claims |
| AbbVieSynthroid | $145 | $32,964687 claims |
| Sanofi-aventis U.S. LLCLantus | $429 | $9,749137 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 143 endocrinology, diabetes & metabolism providers in Puerto Rico.
Other endocrinology, diabetes & metabolism in Rio Piedras
- Rafael GonzalezRio Piedras$47K
- Jose Garcia MateoPonce$945K
- 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
- Altagracia Alcantara GonzalezBayamon$58K
- Jean Pujals KuryBayamon$50K
- Paola Mansilla-LetelierBayamon$33K
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.