Rafael Nunez, MD
Internal Medicine · West Palm Beach, FLNPI 1043208895
Payments from drug & device makers
Across 336 payments — averaging $13,690 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Genentech, Inc.$3.8M
- Seqirus USA Inc$405K
- Biogen$175K
- Pfizer$102K
- Romark Laboratories, LC$48K
- Sanofi US Services Inc.$38K
- plus $42K from 14 others
What the payments were for
- Food & beverage$413100%
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 |
|---|---|---|
| Genentech, Inc. | 112 | $3,789,197 |
| Seqirus USA Inc | 131 | $405,230 |
| Biogen | 2 | $174,696 |
| Pfizer | 51 | $102,420 |
| Romark Laboratories, LC | 1 | $48,039 |
| Sanofi US Services Inc. | 7 | $37,976 |
| Teva Pharmaceuticals USA, Inc. | 13 | $26,639 |
| Shionogi Inc | 4 | $9,851 |
| E.r. Squibb & Sons, L.L.C. | 1 | $4,500 |
| Chiesi USA, Inc. | 1 | $750 |
| Merz North America, Inc. | 1 | $128 |
| Hologic Sales And Service, LLC | 3 | $64 |
| Intuitive Surgical | 1 | $51 |
| Cranial Technologies, Inc | 2 | $29 |
| Exact Sciences | 1 | $28 |
| Phadia US Inc. | 1 | $24 |
| Abbott | 1 | $22 |
| Dexcom, Inc. | 1 | $22 |
| Cipher Pharmaceuticals US LLC | 1 | $14 |
| GSK | 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.
- XEOMIN$128
How this compares
$4,599,693 in reported general payments places this provider in the 95th percentile of 8,530 internal medicine 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 |
|---|---|---|
| Rosuvastatin Calcium | 13 | $212 |
| Famotidine | 12 | $177 |
| Atorvastatin Calcium | 21 | $126 |
| Metformin Hcl | 14 | $60 |
| Losartan Potassium | 11 | $54 |
| Amlodipine Besylate | 11 | $37 |
Paid to pharmacies, not to this prescriber.
Other internal medicine in West Palm Beach
- Mira BaronWest Palm Beach$29.6M
- Yaneicy Gonzalez RojasCoral Gables$93.5M
- Juan Carlos RondonHollywood$66.8M
- Jaynier MoyaPembroke Pines$45.4M
- Mark KutnerMiami$35.7M
- Gilberto JimenezHialeah$35.6M
- William SanchezHialeah$28.9M
- Nelia Sanchez-CrespoHollywood$28.8M
- Kwabena AyesuOrlando$27.6M
- Michael DeverWindermere$24M
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.