Rafael Espinet Perez, MD
Internal Medicine · Ponce, PRNPI 1487845780
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 99.5% of the total across 288 separate payments, which is the pattern of a clinician who attends manufacturer presentations rather than one with a consulting arrangement. 23 manufacturers reported payments, led by AstraZeneca at 31.7% of the total. Among internal medicine 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 288 payments — averaging $25.07 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- AstraZeneca$2K
- Johnson & Johnson$719
- Boston Scientific$653
- PBG Puerto Rico LLC$504
- E.r. Squibb & Sons, L.L.C.$501
- ZOLL Services LLC (a/k/a ZOLL Lifecor Corp)$492
- plus $2K from 17 others
What the payments were for
- Food & beverage$7,186100%
- Education$340%
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 |
|---|---|---|
| AstraZeneca | 98 | $2,286 |
| Johnson & Johnson | 23 | $719 |
| Boston Scientific | 10 | $653 |
| PBG Puerto Rico LLC | 25 | $504 |
| E.r. Squibb & Sons, L.L.C. | 14 | $501 |
| ZOLL Services LLC (a/k/a ZOLL Lifecor Corp) | 28 | $492 |
| Boehringer Ingelheim | 19 | $401 |
| Sanofi-aventis U.S. LLC | 15 | $309 |
| Bayer | 4 | $196 |
| Bayer Puerto Rico Inc. | 8 | $195 |
| Dexcom, Inc. | 4 | $194 |
| Medtronic | 2 | $171 |
| Merck | 13 | $161 |
| GSK | 7 | $127 |
| AbbVie | 6 | $101 |
| Novo Nordisk | 4 | $81 |
| Biotronik Inc. | 1 | $24 |
| Eli Lilly Export S.A. Puerto Rico Branch | 2 | $23 |
| Amgen | 1 | $20 |
| Chiesi USA, Inc. | 1 | $19 |
| Hikma Pharmaceuticals USA | 1 | $18 |
| Novartis | 1 | $12 |
| Baxter Healthcare | 1 | $11 |
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
$7,220 in reported general payments places this provider in the 95th percentile of 1,043 internal medicine 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 |
|---|---|---|
| FarxigaDapagliflozin Propanediol | 201 | $159,402 |
| EliquisApixaban | 133 | $110,954 |
| Xigduo XrDapaglifloz Propaned/Metformin | 101 | $59,370 |
| SynthroidLevothyroxine Sodium | 728 | $56,090 |
| OzempicSemaglutide | 54 | $55,941 |
| JardianceEmpagliflozin | 61 | $51,365 |
| Janumet XrSitagliptin Phos/Metformin Hcl | 56 | $48,054 |
| XareltoRivaroxaban | 44 | $46,830 |
| MounjaroTirzepatide | 42 | $43,813 |
| TradjentaLinagliptin | 57 | $39,575 |
| Trijardy XrEmpaglifloz/Linaglip/Metformin | 53 | $37,468 |
| BrilintaTicagrelor | 54 | $36,073 |
| Jentadueto XrLinagliptin/Metformin Hcl | 45 | $35,751 |
| JentaduetoLinagliptin/Metformin Hcl | 31 | $34,313 |
| Synjardy XrEmpagliflozin/Metformin Hcl | 37 | $33,616 |
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 |
|---|---|---|
| Boehringer IngelheimJardiance, Tradjenta, Trijardy Xr, Jentadueto Xr, Jentadueto | $401 | $276,925338 claims |
| AstraZenecaFarxiga, Brilinta, Symbicort | $2,286 | $202,288283 claims |
| MerckJanumet Xr, Januvia, Janumet | $161 | $91,822105 claims |
| AbbVieSynthroid | $101 | $56,090728 claims |
| Novo NordiskOzempic | $81 | $55,94154 claims |
| Johnson & JohnsonXarelto | $719 | $46,83044 claims |
| GSKBreo Ellipta, Trelegy Ellipta | $127 | $24,73752 claims |
| NovartisEntresto | $12 | $12,80316 claims |
| Sanofi-aventis U.S. LLCLantus | $309 | $11,971136 claims |
| BayerKerendia | $196 | $9,14912 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 1,043 internal medicine providers in Puerto Rico.
Other internal medicine in Ponce
- Hector Martinez FornaPonce$19K
- Elizabeth BarrancoPonce$15K
- Enrique Rodriguez-PazPonce$14K
- Carlos RiveraPonce$12K
- Darcy Diago BlancoPonce$10K
- Brian Torres MercadoPonce$6K
- Raul Cota LeyPonce$6K
- Humberto SimonettiPonce$6K
- Stephen Bury FiolPonce$5K
- Eduardo Colon MelendezPonce$5K
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.