Has Rafael Franjul Juliao, MD received payments from drug or device companies?

Yes. Drug and device makers reported $15,016 in general payments to Rafael Franjul Juliao, MD across 52 transactions between 2019–2025. Most Open Payments records nationally are meals worth under $20; a reported payment is not evidence of wrongdoing.

Does a payment mean Rafael Franjul Juliao, MD did something wrong?

No. Federal law requires drug and device makers to report almost every transfer of value to a physician, including a $14 sandwich at a lunch presentation. Consulting fees, research funding and royalties to device inventors are ordinary, legal parts of medicine. This site reports what was disclosed; it makes no allegation.

Where does this information about Rafael Franjul Juliao, MD come from?

The U.S. Centers for Medicare & Medicaid Services. Payments come from Open Payments, published under the Physician Payments Sunshine Act. Billing and prescribing figures come from the Medicare Physician & Other Practitioners and Part D Prescriber public use files for 2024.

Rafael Franjul Juliao, MD

Pulmonary Disease · San Juan, PRNPI 1063472983

Payments from drug & device makers

What this record shows

This record is dominated by speaking fees: $11,725 of the $15,016 with a category attached, or 78.1%. Pfizer accounts for 80.1% of it on its own, with 10 other manufacturers making up the rest. Reporting peaked in 2022 at $7,313 and has fallen 97.3% since, to $196 in 2025. Among pulmonary disease clinicians in PR with any reported payments, this total sits in the top 10% — high for the specialty, which is a reason to read the composition above rather than the number alone.

$15,016in general payments, 2019–2025

Across 52 payments — averaging $288.77 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.

Pfizer$12K
Merck$2K
AstraZeneca$401
GSK$389
Amgen$148
Johnson & Johnson$100
plus $285 from 5 others

What the payments were for

Consulting fees$1,50010%
Speaking & faculty fees$11,72578%
Food & beverage$1,79112%

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
Pfizer	11	$12,026
Merck	3	$1,669
AstraZeneca	5	$401
GSK	14	$389
Amgen	10	$148
Johnson & Johnson	1	$100
E.r. Squibb & Sons, L.L.C.	1	$99
Boehringer Ingelheim	2	$88
PBG Puerto Rico LLC	3	$69
Corcept Therapeutics	1	$16
Mylan LLC	1	$13

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.

PREVNAR 20$10,450
ABRYSVO$1,400
AIRSUPRA$244
CAPVAXIVE$120
FASENRA$119
XARELTO$100

How this compares

$15,016 in reported general payments places this provider in the 90th percentile of 138 pulmonary disease providers in Puerto Rico.

See all pulmonary disease providers in Puerto Rico →

Medicare billing

Part B allowed, 2024

$3,563

Medicare patients

Services billed

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
Trelegy ElliptaFluticasone/Umeclidin/Vilanter	222	$150,019
Budesonide-Formoterol FumarateBudesonide/Formoterol Fumarate	191	$47,946
Breo ElliptaFluticasone/Vilanterol	49	$20,263
SymbicortBudesonide/Formoterol Fumarate	59	$14,554
Atrovent HfaIpratropium Bromide	18	$8,520
Wixela InhubFluticasone Propion/Salmeterol	46	$8,112
Advair HfaFluticasone Propion/Salmeterol	21	$7,641
Spiriva RespimatTiotropium Bromide	14	$7,555
Fluticasone-SalmeterolFluticasone Propion/Salmeterol	53	$7,044
Anoro ElliptaUmeclidinium Brm/Vilanterol Tr	14	$6,714
Fluticasone Propionate HfaFluticasone Propionate	29	$6,560
Spiriva HandihalerTiotropium Bromide	11	$5,698
Fluticasone Propionate	258	$5,117
Prednisolone Sodium Phosphate	133	$3,669
Advair DiskusFluticasone Propion/Salmeterol	14	$3,497

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
GSKTrelegy Ellipta, Breo Ellipta, Anoro Ellipta	$389	$176,995285 claims
AstraZenecaSymbicort	$401	$14,55459 claims
Boehringer IngelheimSpiriva Respimat	$88	$7,55514 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 90th percentile of 138 pulmonary disease providers in Puerto Rico.

Other pulmonary disease in San Juan

See the full list for Puerto Rico →

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.

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