RxDoctor Payments Data

Nicolle Canales Ramos, MD

Endocrinology, Diabetes & Metabolism · Caguas, PRNPI 1740636026

Payments from drug & device makers

What this record shows

Almost everything reported here is food and beverage — 90.3% of the total across 372 separate payments, which is the pattern of a clinician who attends manufacturer presentations rather than one with a consulting arrangement. It is spread thinly across 23 manufacturers, the largest accounting for just 13.4% — the pattern of someone who eats at a lot of different presentations.

$12,357in general payments, 2019–2025

Across 372 payments — averaging $33.22 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.

  • Sanofi-aventis U.S. LLC$2K
  • Medtronic$2K
  • Amgen$1K
  • Boehringer Ingelheim$1K
  • Novo Nordisk$1K
  • Eli Lilly Export S.A. Puerto Rico Branch$934
  • plus $4K from 17 others

What the payments were for

  • Consulting fees$3753%
  • Travel & lodging$7246%
  • Food & beverage$11,16390%
  • Education$951%

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

19
20
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.

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

$12,357 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

Part B allowed, 2024
$9,551
Medicare patients
27
Services billed
83

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
OzempicSemaglutide131$135,484
TrulicityDulaglutide104$102,805
Trijardy XrEmpaglifloz/Linaglip/Metformin136$93,100
JardianceEmpagliflozin75$55,104
FarxigaDapagliflozin Propanediol65$48,583
Janumet XrSitagliptin Phos/Metformin Hcl70$47,358
TradjentaLinagliptin66$40,275
MounjaroTirzepatide38$39,818
Synjardy XrEmpagliflozin/Metformin Hcl51$34,969
Jentadueto XrLinagliptin/Metformin Hcl61$32,161
Soliqua 100-33Insulin Glargine/Lixisenatide32$28,650
Xigduo XrDapaglifloz Propaned/Metformin46$25,542
SynthroidLevothyroxine Sodium488$24,258
JanuviaSitagliptin Phosphate25$15,394
HumalogInsulin Lispro80$12,195

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 IngelheimTrijardy Xr, Jardiance, Tradjenta, Synjardy Xr, Jentadueto Xr$1,342$265,609404 claims
Lilly USA, LLCTrulicity, Mounjaro, Humalog, Insulin Lispro$242$155,268233 claims
Novo NordiskOzempic$1,327$135,484131 claims
MerckJanumet Xr, Januvia$169$62,75295 claims
AstraZenecaFarxiga$126$48,58365 claims
Sanofi-aventis U.S. LLCSoliqua 100-33, Lantus$1,660$40,166145 claims
AbbVieSynthroid$631$24,258488 claims
BayerKerendia$529$7,34111 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 Caguas

See the full list for Puerto Rico

Where these figures come from

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