Rafaelito Victoria, MD
Internal Medicine · la Palma, CANPI 1548363989
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 99.9% of the total across 145 separate payments, which is the pattern of a clinician who attends manufacturer presentations rather than one with a consulting arrangement. 19 manufacturers reported payments, led by Johnson & Johnson at 33.1% of the total. Reporting peaked in 2021 at $1,488 and has fallen 61.7% since, to $570 in 2025. Among internal medicine clinicians in CA 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 145 payments — averaging $38.21 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Johnson & Johnson$2K
- Novo Nordisk$869
- Amarin Pharma, Inc.$851
- Bayer$380
- Amgen$337
- Merck$256
- plus $1K from 13 others
Across 183 payments — averaging $41,659 each. Payments tied to a research study. These frequently flow through the physician to a hospital or research institution rather than to the physician personally.
- Bavarian Nordic A/s$3.4M
- Regeneron$3.4M
- Pfizer$776K
- Eli Lilly$4K
- Abbott$3K
- Swedish Orphan Biovitrum AB$2K
- plus $2K from 1 others
What the payments were for
- Food & beverage$5,535100%
- Education$60%
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 |
|---|---|---|
| Johnson & Johnson | 50 | $1,835 |
| Novo Nordisk | 14 | $869 |
| Amarin Pharma, Inc. | 31 | $851 |
| Bayer | 5 | $380 |
| Amgen | 13 | $337 |
| Merck | 13 | $256 |
| AbbVie | 2 | $250 |
| Edwards Lifesciences | 2 | $169 |
| Redhill Biopharma Inc. | 1 | $146 |
| Cleerly, Inc. | 1 | $123 |
| Boehringer Ingelheim | 3 | $119 |
| AstraZeneca | 3 | $54 |
| Cipher Pharmaceuticals US LLC | 1 | $34 |
| Emergent Biosolutions Inc. | 1 | $23 |
| Esperion Therapeutics, Inc. | 1 | $23 |
| Sunovion Pharmaceuticals Inc. | 1 | $22 |
| Dexcom, Inc. | 1 | $17 |
| Novartis | 1 | $17 |
| Salix Pharmaceuticals, A Division Of Bausch Health US, LLC | 1 | $15 |
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.
- XARELTO$844
- Kerendia$364
- Vascepa$263
- Ozempic$236
- RYBELSUS$222
- Edwards SAPIEN 3 Transcatheter Heart Valve$160
- Talicia$146
- TEFLARO$125
- DALVANCE$125
- EMBLAVEO$125
- Cleerly Ischemia$123
- Cleerly Labs$123
How this compares
$5,541 in reported general payments places this provider in the 90th percentile of 13,581 internal medicine providers in California.
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 |
|---|---|---|
| JardianceEmpagliflozin | 64 | $64,488 |
| JanuviaSitagliptin Phosphate | 44 | $46,967 |
| EliquisApixaban | 70 | $44,296 |
| KerendiaFinerenone | 47 | $41,351 |
| OzempicSemaglutide | 25 | $30,553 |
| TradjentaLinagliptin | 30 | $20,873 |
| InvokanaCanagliflozin | 16 | $15,437 |
| Tresiba Flextouch U-100Insulin Degludec | 19 | $15,436 |
| FarxigaDapagliflozin Propanediol | 12 | $15,203 |
| VascepaIcosapent Ethyl | 29 | $14,842 |
| Atorvastatin Calcium | 397 | $3,743 |
| Lantus SolostarInsulin Glargine,hum.Rec.Anlog | 34 | $3,315 |
| Febuxostat | 19 | $3,087 |
| Losartan Potassium | 335 | $2,860 |
| Humulin 70/30 KwikpenInsulin Nph Hum/Reg Insulin Hm | 11 | $2,499 |
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 | $119 | $85,36194 claims |
| MerckJanuvia | $256 | $46,96744 claims |
| BayerKerendia | $380 | $41,35147 claims |
| Novo NordiskOzempic | $869 | $30,55325 claims |
| Johnson & JohnsonInvokana | $1,835 | $15,43716 claims |
| AstraZenecaFarxiga | $54 | $15,20312 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 13,581 internal medicine providers in California.
Other internal medicine in la Palma
- Andrew ChengSouth San Francisco$55.1M
- Tung NgoNewport Beach$4.9M
- Christian EversullStanford$2.9M
- Christian SandrockSacramento$2.1M
- Hatim HusainSan Diego$2M
- Teck LingPalo Alto$1.1M
- Hyong Kimla Jolla$1M
- Rohit Loombala Jolla$965K
- Fred CohenSan Francisco$929K
- Steven EdelmanSan Diego$863K
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.