Rafael Soto Bermudez, MD
General Practice · Toa Baja, PRNPI 1932105665
Payments from drug & device makers
What this record shows
This record is dominated by food and beverage: $6,119 of the $7,632 with a category attached, or 80.2%. 20 manufacturers reported payments, led by AstraZeneca at 30.7% of the total. Reporting peaked in 2019 at $2,641 and has fallen 79.4% since, to $543 in 2025. Among general practice 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 290 payments — averaging $26.32 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- AstraZeneca$2K
- Merck$2K
- Sanofi-aventis U.S. LLC$663
- Eli Lilly Export S.A. Puerto Rico Branch$470
- Boehringer Ingelheim$451
- Novo Nordisk$400
- plus $1K from 14 others
What the payments were for
- Consulting fees$1,50020%
- Food & beverage$6,11980%
- Education$130%
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 | 106 | $2,347 |
| Merck | 19 | $1,865 |
| Sanofi-aventis U.S. LLC | 36 | $663 |
| Eli Lilly Export S.A. Puerto Rico Branch | 23 | $470 |
| Boehringer Ingelheim | 29 | $451 |
| Novo Nordisk | 16 | $400 |
| Johnson & Johnson | 16 | $360 |
| PBG Puerto Rico LLC | 11 | $264 |
| GSK | 8 | $243 |
| Dexcom, Inc. | 6 | $121 |
| Biohaven Pharmaceutical Holding Company Ltd. | 5 | $111 |
| Teva Pharmaceuticals USA, Inc. | 4 | $96 |
| Exact Sciences | 2 | $50 |
| Amgen | 2 | $50 |
| Bayer | 2 | $35 |
| AbbVie | 1 | $25 |
| E.r. Squibb & Sons, L.L.C. | 1 | $23 |
| Pfizer Pharmaceuticals LLC | 1 | $20 |
| Genentech USA, Inc. | 1 | $20 |
| Takeda Pharmaceuticals U.S.A., Inc. | 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.
How this compares
$7,632 in reported general payments places this provider in the 95th percentile of 3,586 general practice 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 | 271 | $261,968 |
| JardianceEmpagliflozin | 207 | $241,589 |
| TrulicityDulaglutide | 195 | $192,844 |
| EliquisApixaban | 190 | $188,352 |
| TradjentaLinagliptin | 101 | $115,540 |
| XareltoRivaroxaban | 132 | $113,589 |
| SynthroidLevothyroxine Sodium | 1,079 | $106,578 |
| OzempicSemaglutide | 99 | $96,629 |
| EnbrelEtanercept | 13 | $93,874 |
| JanumetSitagliptin Phos/Metformin Hcl | 69 | $68,791 |
| JanuviaSitagliptin Phosphate | 44 | $62,027 |
| SynjardyEmpagliflozin/Metformin Hcl | 58 | $56,849 |
| Xigduo XrDapaglifloz Propaned/Metformin | 48 | $48,845 |
| LinzessLinaclotide | 44 | $43,604 |
| GlyxambiEmpagliflozin/Linagliptin | 36 | $42,845 |
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, Glyxambi, Trijardy Xr | $451 | $552,216516 claims |
| AstraZenecaFarxiga | $2,347 | $261,968271 claims |
| AbbVieSynthroid, Linzess, Lumigan, Creon | $25 | $185,6861,200 claims |
| MerckJanumet, Januvia, Janumet Xr | $1,865 | $161,834161 claims |
| AmgenEnbrel, Prolia | $50 | $115,32325 claims |
| Johnson & JohnsonXarelto | $360 | $113,589132 claims |
| Novo NordiskOzempic | $400 | $96,62999 claims |
| Sanofi-aventis U.S. LLCLantus, Soliqua 100-33 | $663 | $44,433233 claims |
| GSKTrelegy Ellipta, Breo Ellipta | $243 | $39,36577 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 3,586 general practice providers in Puerto Rico.
Other general practice in Toa Baja
- William Soto AvilesToa Baja$63K
- Wilfredo CuevasSan Lorenzo$530K
- Julio BacoMayaguez$268K
- Soria Diaz BaezPonce$192K
- Carlos RomanCanovanas$140K
- William E TorresSan Juan$86K
- Rafael Mendoza RodriguezPonce$77K
- Frank Perez NogueiraSan German$70K
- Vivian Tamayo AgraitSan Juan$64K
- Jessica RosarioSanturce$41K
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.