Rafael Santini Dominguez, MD
Vascular Surgery · Ponce, PRNPI 1720347479
Payments from drug & device makers
What this record shows
This record is dominated by food and beverage: $6,045 of the $7,506 with a category attached, or 80.5%. 19 manufacturers reported payments, led by Medtronic at 31.9% of the total.
Across 177 payments — averaging $42.40 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Medtronic$2K
- Bard Peripheral Vascular, Inc.$929
- BD$873
- W. L. Gore & Associates, Inc.$866
- Silk Road Medical, Inc.$633
- Cook Incorporated$586
- plus $1K from 13 others
What the payments were for
- Travel & lodging$1,05714%
- Food & beverage$6,04581%
- Education$4045%
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 |
|---|---|---|
| Medtronic(2 entities) | 86 | $2,392 |
| Bard Peripheral Vascular, Inc. | 22 | $929 |
| BD | 25 | $873 |
| W. L. Gore & Associates, Inc. | 5 | $866 |
| Silk Road Medical, Inc. | 7 | $633 |
| Cook Incorporated | 2 | $586 |
| Lemaitre Vascular, Inc. | 4 | $295 |
| Cook Medical LLC | 4 | $269 |
| Johnson & Johnson | 7 | $257 |
| Boston Scientific | 4 | $135 |
| Bard Access Systems, Inc. | 1 | $64 |
| Abbott | 2 | $43 |
| Chiesi USA, Inc. | 2 | $38 |
| Edwards Lifesciences | 1 | $28 |
| Bolton Medical Inc | 1 | $23 |
| Smith+Nephew | 1 | $20 |
| PBG Puerto Rico LLC | 1 | $19 |
| Cordis US CORP. | 1 | $19 |
| Terumo Medical Corporation | 1 | $16 |
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.
- Cook Medical AFEN$586
- GORE-TEX Vascular Graft$404
- ENROUTE Transcarotid Neuroprotection System$382
- EXCLUDER Conformable AAA Endoprosthesis with Active Control$259
- ENROUTE Transcarotid Stent System$232
- ENHANCE Transcarotid Peripheral Access Kit$232
- ENROUTE 0.014 Guidewire$232
- Cook Medical AAA$159
- ENDURANT IIS$151
- ENROUTE Transcarotid Stent$150
- Ellipsys$144
- Lutonix Drug Coated Balloon$133
- Valiant Captivia$126
- Artegraft$125
- ARTEGRAFT VASCULAR GRAFT$118
- IN.PACT Admiral$104
- GORE TAG Thoracic Branch Endoprosthesis$102
- WAVELINQ$101
- GORE BIO-A Tissue Reinforcement$100
How this compares
$7,506 in reported general payments places this provider in the 65th percentile of 20 vascular surgery 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 |
|---|---|---|
| XareltoRivaroxaban | 114 | $74,387 |
| EliquisApixaban | 77 | $45,611 |
| SantylCollagenase Clostridium Hist. | 14 | $4,312 |
| Gabapentin | 112 | $972 |
| ClopidogrelClopidogrel Bisulfate | 94 | $768 |
| Cilostazol | 19 | $680 |
| Atorvastatin Calcium | 83 | $590 |
| Warfarin Sodium | 43 | $510 |
| Amoxicillin-Clavulanate PotassAmoxicillin/Potassium Clav | 25 | $423 |
| Pregabalin | 19 | $288 |
| Acetaminophen-CodeineAcetaminophen With Codeine | 23 | $251 |
| Oxycodone-AcetaminophenOxycodone Hcl/Acetaminophen | 33 | $219 |
| Diazepam | 18 | $34 |
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 |
|---|---|---|
| Johnson & JohnsonXarelto | $257 | $74,387114 claims |
| Smith+NephewSantyl | $20 | $4,31214 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 65th percentile of 20 vascular surgery providers in Puerto Rico.
Other vascular surgery in Ponce
- Gabriel Pereira TorrellasPonce$9K
- Jorge Martinez TrabalPonce$8K
- Carlos Rivera-CabanPonce$5K
- Osvaldo Santiago GonzaPonce$4K
- Luis TorruellaPonce$3K
- Fernando Joglar-IrizarrySan Juan$48K
- Ivan DominguezSan Juan$37K
- Leonardo ValentinManati$12K
- Cesar Castillo AliceaSan Juan$10K
- Angel Menendez-AponteBayamon$7K
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.