Rachel Agustines, MD
Child & Adolescent Psychiatry · Largo, FLNPI 1386617306
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 99.9% of the total across 807 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 32 manufacturers, the largest accounting for just 14.1% — the pattern of someone who eats at a lot of different presentations. 2025 is the largest year on record at $4,252, 3.2 times the $1,338 reported in 2019. Among child & adolescent psychiatry clinicians in FL 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 807 payments — averaging $20.04 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Neurocrine Biosciences, Inc.$2K
- AbbVie$2K
- Axsome Therapeutics, Inc.$1K
- Supernus Pharmaceuticals, Inc.$1K
- Otsuka America Pharmaceutical, Inc.$1K
- Teva Pharmaceuticals USA, Inc.$1K
- plus $7K from 26 others
What the payments were for
- Food & beverage$16,159100%
- Education$170%
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 |
|---|---|---|
| Neurocrine Biosciences, Inc. | 104 | $2,279 |
| AbbVie(2 entities) | 88 | $2,030 |
| Axsome Therapeutics, Inc. | 45 | $1,441 |
| Supernus Pharmaceuticals, Inc. | 79 | $1,312 |
| Otsuka America Pharmaceutical, Inc. | 65 | $1,182 |
| Teva Pharmaceuticals USA, Inc. | 80 | $1,167 |
| ITI, Inc. (d/b/a Intra-cellular Therapies, Inc.) | 46 | $923 |
| Alkermes, Inc. | 41 | $769 |
| Sunovion Pharmaceuticals Inc. | 33 | $590 |
| Tris Pharma Inc | 32 | $584 |
| Ironshore Pharmaceuticals Inc. | 25 | $476 |
| Lundbeck LLC | 21 | $392 |
| Noven Therapeutics, LLC | 20 | $372 |
| Takeda Pharmaceuticals U.S.A., Inc. | 16 | $339 |
| Bausch Health US, LLC | 19 | $330 |
| Johnson & Johnson | 16 | $308 |
| Corium, LLC | 12 | $279 |
| Idorsia Pharmaceuticals US Inc | 16 | $272 |
| E.r. Squibb & Sons, L.L.C. | 11 | $260 |
| Almatica Pharma LLC | 10 | $229 |
| Jazz Pharmaceuticals Inc. | 5 | $101 |
| Biogen | 1 | $95 |
| Collegium Pharmaceutical, Inc. | 4 | $75 |
| Eisai Inc. | 3 | $63 |
| Neos Therapeutics, LP | 4 | $62 |
| Shire North American Group Inc | 3 | $57 |
| Sage Therapeutics, LLC | 2 | $57 |
| Livanova USA, Inc. | 2 | $48 |
| Arbor Pharmaceuticals, Inc. | 1 | $33 |
| Harmony Biosciences LLC | 1 | $22 |
| Alfasigma USA, Inc. | 1 | $18 |
| Merck | 1 | $12 |
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
$16,175 in reported general payments places this provider in the 95th percentile of 206 child & adolescent psychiatry providers in Florida.
See all child & adolescent psychiatry providers in Florida →
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 |
|---|---|---|
| IngrezzaValbenazine Tosylate | 12 | $101,976 |
| VraylarCariprazine Hcl | 25 | $46,731 |
| Vilazodone Hcl | 76 | $8,821 |
| Paliperidone ErPaliperidone | 16 | $5,964 |
| BelsomraSuvorexant | 12 | $5,286 |
| Bupropion XlBupropion Hcl | 133 | $4,185 |
| Quetiapine Fumarate | 125 | $3,794 |
| Ziprasidone Hcl | 45 | $3,466 |
| Lurasidone Hcl | 20 | $2,961 |
| Trazodone Hcl | 142 | $2,603 |
| Dextroamphetamine-Amphet ErDextroamphetamine/Amphetamine | 35 | $2,450 |
| Duloxetine Hcl | 79 | $2,228 |
| Desvenlafaxine Succinate ErDesvenlafaxine Succinate | 38 | $2,197 |
| Methylphenidate ErMethylphenidate Hcl | 17 | $1,933 |
| Lamotrigine | 95 | $1,781 |
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 |
|---|---|---|
| Neurocrine Biosciences, Inc.Ingrezza | $2,279 | $101,97612 claims |
| AbbVieVraylar | $2,030 | $46,73125 claims |
| MerckBelsomra | $12 | $5,28612 claims |
| Almatica Pharma LLCSertraline Hcl | $229 | $25655 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 206 child & adolescent psychiatry providers in Florida.
Other child & adolescent psychiatry in Largo
- Craig KuninsGulfport$265K
- Elias SarkisGainesville$169K
- Jeffrey AlvaroSt Petersburg$87K
- Rosa Negron MunozLakeland$39K
- Sean HoranMiami$17K
- Carlos BorgeSarasota$15K
- Justin SpoonerPonte Vedra Beach$12K
- Bhaskar RajuOrlando$11K
- Americo PadillaMiami$11K
- Marcos CintronHialeah$10K
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.