Rafael Gonzalez, MD
Endocrinology, Diabetes & Metabolism · Rio Piedras, PRNPI 1144427758
Payments from drug & device makers
What this record shows
This record is dominated by speaking fees: $32,738 of the $46,700 with a category attached, or 70.1%. 15 manufacturers reported payments, led by Boehringer Ingelheim at 58.1% of the total. Reporting peaked in 2020 at $14,089 and has fallen 94.1% since, to $826 in 2025. Among endocrinology, diabetes & metabolism 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.
Across 164 payments — averaging $284.76 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Boehringer Ingelheim$27K
- Lilly USA, LLC$8K
- Merck$7K
- Johnson & Johnson$2K
- Medtronic$871
- Sanofi-aventis U.S. LLC$435
- plus $2K from 9 others
What the payments were for
- Consulting fees$8,47018%
- Speaking & faculty fees$32,73870%
- Travel & lodging$1,5873%
- Food & beverage$3,7908%
- Education$1160%
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 |
|---|---|---|
| Boehringer Ingelheim | 49 | $27,137 |
| Lilly USA, LLC | 8 | $7,963 |
| Merck | 24 | $6,691 |
| Johnson & Johnson | 4 | $2,003 |
| Medtronic | 10 | $871 |
| Sanofi-aventis U.S. LLC | 7 | $435 |
| AbbVie | 3 | $412 |
| Novo Nordisk | 20 | $397 |
| Abbott | 8 | $184 |
| AstraZeneca | 10 | $172 |
| Eli Lilly Export S.A. Puerto Rico Branch | 7 | $155 |
| Dexcom, Inc. | 7 | $129 |
| Amgen | 4 | $95 |
| PBG Puerto Rico LLC | 2 | $37 |
| Bayer | 1 | $20 |
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.
- JARDIANCE$34,346
- STEGLATRO$3,600
- INVOKANA$1,976
- MINIMED 780G$599
- Synthroid$375
- SOTAGLIFLOZIN$300
How this compares
$46,700 in reported general payments places this provider in the 90th percentile of 143 endocrinology, diabetes & metabolism providers in Puerto Rico.
See all endocrinology, diabetes & metabolism 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 |
|---|---|---|
| TrulicityDulaglutide | 560 | $583,584 |
| JardianceEmpagliflozin | 591 | $440,854 |
| FarxigaDapagliflozin Propanediol | 511 | $330,681 |
| OzempicSemaglutide | 293 | $291,582 |
| TradjentaLinagliptin | 441 | $264,827 |
| Synjardy XrEmpagliflozin/Metformin Hcl | 332 | $228,388 |
| JanuviaSitagliptin Phosphate | 301 | $211,041 |
| Janumet XrSitagliptin Phos/Metformin Hcl | 296 | $190,393 |
| SynthroidLevothyroxine Sodium | 2,912 | $181,718 |
| Trijardy XrEmpaglifloz/Linaglip/Metformin | 241 | $160,796 |
| MounjaroTirzepatide | 121 | $138,403 |
| Jentadueto XrLinagliptin/Metformin Hcl | 174 | $96,023 |
| GlyxambiEmpagliflozin/Linagliptin | 113 | $77,823 |
| Xigduo XrDapaglifloz Propaned/Metformin | 120 | $77,248 |
| JanumetSitagliptin Phos/Metformin Hcl | 65 | $59,545 |
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, Synjardy Xr, Trijardy Xr, Jentadueto Xr | $27,137 | $1,308,8851,958 claims |
| Lilly USA, LLCTrulicity, Mounjaro, Humalog, Humalog Mix 75-25, Humulin 70-30 | $7,963 | $775,3561,122 claims |
| MerckJanuvia, Janumet Xr, Janumet | $6,691 | $460,980662 claims |
| AstraZenecaFarxiga | $172 | $330,681511 claims |
| Novo NordiskOzempic | $397 | $291,582293 claims |
| AbbVieSynthroid | $412 | $181,7182,912 claims |
| Sanofi-aventis U.S. LLCLantus, Soliqua 100-33 | $435 | $67,943517 claims |
| AmgenProlia | $95 | $51,11029 claims |
| Johnson & JohnsonXarelto, Invokana | $2,003 | $25,88046 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 143 endocrinology, diabetes & metabolism providers in Puerto Rico.
Other endocrinology, diabetes & metabolism in Rio Piedras
- Milliette Alvarado SantiagoRio Piedras$75K
- Jose Garcia MateoPonce$945K
- Manuel Alegre-HernandezSan Juan$156K
- Monica Ortiz-RiveraSan Juan$148K
- Alex Gonzalez BossoloSan Juan$110K
- Michelle Mangual GarciaSan Juan$87K
- Meliza Martinez RodriguezSan Juan$80K
- Altagracia Alcantara GonzalezBayamon$58K
- Jean Pujals KuryBayamon$50K
- Paola Mansilla-LetelierBayamon$33K
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.