Rafael Bloise Espinal, MD
Hospice and Palliative Medicine · Norwood, MANPI 1689933392
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 100.0% of the total across 6 separate payments, which is the pattern of a clinician who attends manufacturer presentations rather than one with a consulting arrangement. Acadia Pharmaceuticals Inc accounts for 95.5% of it on its own, with 1 other manufacturer making up the rest. Reporting peaked in 2024 at $253 and has fallen 60.0% since, to $101 in 2025.
Across 6 payments — averaging $99.16 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Acadia Pharmaceuticals Inc$568
- Johnson & Johnson$26
What the payments were for
- Food & beverage$595100%
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 |
|---|---|---|
| Acadia Pharmaceuticals Inc | 5 | $568 |
| Johnson & Johnson | 1 | $26 |
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.
- NUPLAZID$568
How this compares
$595 in reported general payments places this provider in the 75th percentile of 31 hospice and palliative medicine providers in Massachusetts.
See all hospice and palliative medicine providers in Massachusetts →
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 |
|---|---|---|
| NuplazidPimavanserin Tartrate | 40 | $98,568 |
| EliquisApixaban | 322 | $94,044 |
| IngrezzaValbenazine Tosylate | 16 | $70,026 |
| JardianceEmpagliflozin | 108 | $33,699 |
| OzempicSemaglutide | 17 | $17,549 |
| Dalfampridine ErDalfampridine | 11 | $14,809 |
| LinzessLinaclotide | 24 | $13,737 |
| MyrbetriqMirabegron | 57 | $12,886 |
| CreonLipase/Protease/Amylase | 16 | $12,455 |
| Trelegy ElliptaFluticasone/Umeclidin/Vilanter | 24 | $10,582 |
| Breo ElliptaFluticasone/Vilanterol | 22 | $9,358 |
| XareltoRivaroxaban | 56 | $9,104 |
| Rasagiline Mesylate | 21 | $8,650 |
| Incruse ElliptaUmeclidinium Bromide | 17 | $6,446 |
| Memantine Hcl | 40 | $5,998 |
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 |
|---|---|---|
| Acadia Pharmaceuticals IncNuplazid | $568 | $98,56840 claims |
| Johnson & JohnsonXarelto | $26 | $9,10456 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 75th percentile of 31 hospice and palliative medicine providers in Massachusetts.
Other hospice and palliative medicine in Norwood
- Charlotta LindvallBoston$14K
- Matthew BartekBoston$7K
- David ChengBoston$4K
- Haipeng ZhangBoston$2K
- Laura PetrilloBoston$1K
- Richard GoldsteinBoston$828
- Mark SkibaMilford$600
- Germaine Earle CruickshanksLeominster$315
- Amanda OrtengrenPlymouth$273
- Christina FitchSpringfield$146
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.