Renato Alfonso, MD
Internal Medicine · Palm Coast, FLNPI 1184619017
Payments from drug & device makers
Across 837 payments — averaging $15.39 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- GSK$2K
- Novo Nordisk$2K
- AbbVie$1K
- Amgen$1K
- Pfizer$872
- AstraZeneca$677
- plus $5K from 44 others
What the payments were for
- Food & beverage$12,78099%
- Education$991%
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.
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
$12,879 in reported general payments places this provider in the 90th 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 |
|---|---|---|
| EliquisApixaban | 155 | $153,973 |
| OzempicSemaglutide | 72 | $114,806 |
| XareltoRivaroxaban | 95 | $112,273 |
| JardianceEmpagliflozin | 69 | $93,078 |
| MounjaroTirzepatide | 58 | $80,076 |
| JanuviaSitagliptin Phosphate | 35 | $56,828 |
| Trelegy ElliptaFluticasone/Umeclidin/Vilanter | 33 | $40,623 |
| OxycontinOxycodone Hcl | 27 | $37,248 |
| RybelsusSemaglutide | 25 | $35,753 |
| FarxigaDapagliflozin Propanediol | 30 | $34,690 |
| Tresiba Flextouch U-100Insulin Degludec | 23 | $30,562 |
| MyrbetriqMirabegron | 33 | $28,620 |
| TrulicityDulaglutide | 15 | $26,098 |
| Hydrocodone-AcetaminophenHydrocodone/Acetaminophen | 826 | $24,743 |
| LinzessLinaclotide | 16 | $24,144 |
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 |
|---|---|---|
| PfizerEliquis, Premarin | $872 | $161,379177 claims |
| Novo NordiskOzempic, Rybelsus | $1,835 | $150,55997 claims |
| Johnson & JohnsonXarelto | $259 | $112,27395 claims |
| Lilly USA, LLCMounjaro, Trulicity | $562 | $106,17473 claims |
| Boehringer IngelheimJardiance | $320 | $93,07869 claims |
| GSKTrelegy Ellipta, Breo Ellipta | $2,079 | $61,28957 claims |
| MerckJanuvia | $209 | $56,82835 claims |
| AstraZenecaFarxiga, Symbicort | $677 | $41,49149 claims |
| AbbVieLinzess, Synthroid | $1,336 | $33,321152 claims |
| Astellas Pharma US IncMyrbetriq | $563 | $28,62033 claims |
| Takeda Pharmaceuticals U.S.A., Inc.Vyvanse | $14 | $9,82521 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 8,530 internal medicine providers in Florida.
Other internal medicine in Palm Coast
- Yaneicy Gonzalez RojasCoral Gables$93.5M
- Juan Carlos RondonHollywood$66.8M
- Jaynier MoyaPembroke Pines$45.4M
- Mark KutnerMiami$35.7M
- Gilberto JimenezHialeah$35.6M
- Mira BaronWest Palm Beach$29.6M
- 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.