Ramon Toro-Torres, MD
Rheumatology · San German, PRNPI 1619007150
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 100.0% of the total across 27 separate payments, which is the pattern of a clinician who attends manufacturer presentations rather than one with a consulting arrangement. 8 manufacturers reported payments, led by Amgen at 34.0% of the total. Reporting peaked in 2019 at $260 and has fallen 63.6% since, to $94 in 2025. That places this record below the midpoint for rheumatology clinicians in PR, where the typical reported total is $2,108.
Across 27 payments — averaging $27.19 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Amgen$250
- E.r. Squibb & Sons, L.L.C.$192
- PBG Puerto Rico LLC$110
- GSK$51
- Hikma Pharmaceuticals USA$46
- Sanofi$43
- plus $42 from 2 others
Across 149 payments — averaging $2203.58 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.
- AbbVie$259K
- Pfizer$43K
- Eli Lilly Export S.A. Puerto Rico Branch$23K
- Eli Lilly$3K
- Amgen$28
What the payments were for
- Food & beverage$734100%
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 |
|---|---|---|
| Amgen | 9 | $250 |
| E.r. Squibb & Sons, L.L.C. | 7 | $192 |
| PBG Puerto Rico LLC | 4 | $110 |
| GSK | 1 | $51 |
| Hikma Pharmaceuticals USA | 2 | $46 |
| Sanofi | 1 | $43 |
| Eli Lilly Export S.A. Puerto Rico Branch | 2 | $32 |
| Pfizer Pharmaceuticals LLC | 1 | $9 |
How this compares
$734 in reported general payments places this provider in the 30th percentile of 88 rheumatology 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 |
|---|---|---|
| Enbrel SureclickEtanercept | 180 | $1,357,632 |
| Humira(Cf) PenAdalimumab | 125 | $866,501 |
| EnbrelEtanercept | 29 | $259,075 |
| Orencia ClickjectAbatacept | 41 | $236,656 |
| Xeljanz XrTofacitinib Citrate | 24 | $150,463 |
| ProliaDenosumab | 85 | $148,319 |
| XeljanzTofacitinib Citrate | 19 | $110,490 |
| Leflunomide | 219 | $10,940 |
| Hydroxychloroquine Sulfate | 347 | $6,986 |
| Cevimeline Hcl | 62 | $5,164 |
| Prednisone | 620 | $4,492 |
| Calcitonin-SalmonCalcitonin,salmon,synthetic | 45 | $3,656 |
| MethotrexateMethotrexate Sodium | 244 | $2,823 |
| Gabapentin | 321 | $1,814 |
| Duloxetine Hcl | 157 | $1,727 |
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 |
|---|---|---|
| AmgenEnbrel, Prolia | $250 | $407,394114 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 30th percentile of 88 rheumatology providers in Puerto Rico.
Other rheumatology in San German
- Radames Sierra ZoritaSan Juan$428K
- Oscar Soto RaicesSan Juan$352K
- Yvonne FontSan Juan$193K
- Paloma AlejandroSan Juan$33K
- Linnette Lopez LopezArecibo$28K
- Jose Rodriguez SantiagoSanturce$26K
- Roberto Alvarez SwihartAibonito$20K
- Amarilis Perez de JesusCaguas$18K
- Roberto Leon-PerezPonce$17K
- Sonialy Lugo RuizAguadilla$17K
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.