Ricardo Alvarado Melendez, MD
Neurology · San Juan, PRNPI 1679776348
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 96.1% of the total across 268 separate payments, which is the pattern of a clinician who attends manufacturer presentations rather than one with a consulting arrangement. It is spread thinly across 24 manufacturers, the largest accounting for just 18.7% — the pattern of someone who eats at a lot of different presentations.
Across 268 payments — averaging $22.82 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- AbbVie$1K
- Eli Lilly Export S.A. Puerto Rico Branch$730
- Novartis$713
- Biogen$691
- PBG Puerto Rico LLC$617
- Sanofi$415
- plus $2K from 18 others
What the payments were for
- Consulting fees$1502%
- Speaking & faculty fees$341%
- Food & beverage$5,87896%
- Education$551%
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 |
|---|---|---|
| AbbVie(2 entities) | 42 | $1,145 |
| Eli Lilly Export S.A. Puerto Rico Branch | 33 | $730 |
| Novartis | 38 | $713 |
| Biogen | 28 | $691 |
| PBG Puerto Rico LLC | 27 | $617 |
| Sanofi | 21 | $415 |
| E.r. Squibb & Sons, L.L.C. | 18 | $409 |
| Genentech USA, Inc. | 17 | $352 |
| UCB, Inc. | 8 | $182 |
| Sunovion Pharmaceuticals Inc. | 8 | $143 |
| Boston Scientific | 2 | $133 |
| Biohaven Pharmaceutical Holding Company Ltd. | 5 | $125 |
| ANI Pharmaceuticals, Inc. | 3 | $68 |
| Johnson & Johnson | 3 | $60 |
| Amgen | 3 | $60 |
| Penumbra, Inc. | 1 | $56 |
| AstraZeneca | 2 | $48 |
| Acorda Therapeutics, Inc | 2 | $34 |
| TG Therapeutics, Inc. | 1 | $28 |
| Teva Pharmaceuticals USA, Inc. | 2 | $26 |
| Eisai Inc. | 1 | $23 |
| Biohaven Pharmaceuticals, Inc. | 1 | $23 |
| Adamas Pharmaceuticals, Inc. | 1 | $19 |
| Pfizer Pharmaceuticals LLC | 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.
- TYSABRI$150
- AVYCAZ$125
- GENERAL - THERAPIES$107
How this compares
$6,117 in reported general payments places this provider in the 80th percentile of 129 neurology 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 |
|---|---|---|
| Kesimpta PenOfatumumab | 12 | $105,990 |
| AustedoDeutetrabenazine | 11 | $58,336 |
| RytaryCarbidopa/Levodopa | 51 | $47,890 |
| Rivastigmine | 207 | $26,300 |
| Memantine Hcl | 570 | $15,367 |
| Nurtec OdtRimegepant Sulfate | 11 | $10,862 |
| NeuproRotigotine | 12 | $10,251 |
| Carbidopa-LevodopaCarbidopa/Levodopa | 261 | $8,530 |
| Donepezil Hcl | 989 | $8,444 |
| Oxcarbazepine | 191 | $7,191 |
| Pramipexole ErPramipexole Di-Hcl | 35 | $7,097 |
| Levetiracetam | 239 | $5,405 |
| Galantamine Hbr | 70 | $5,337 |
| Pyridostigmine Bromide ErPyridostigmine Bromide | 18 | $5,319 |
| Pyridostigmine Bromide | 56 | $4,835 |
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 |
|---|---|---|
| Teva Pharmaceuticals USA, Inc.Austedo | $26 | $58,33611 claims |
| UCB, Inc.Neupro | $182 | $10,25112 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 80th percentile of 129 neurology providers in Puerto Rico.
Other neurology in San Juan
- Franchesca Fiorito-TorresSan Juan$453K
- Mari GarciaSan Juan$138K
- Cristina Cabret-AymatSan Juan$108K
- Gishlaine Alfonso MendezSan Juan$53K
- Carlos Luciano-RomanSan Juan$21K
- Maria Garcia-AyalaSan Juan$10K
- Marisol Mubarak PerdomoSan Juan$10K
- Enrique Rodriguez OlaverriSan Juan$8K
- Hector Miranda DelgadoSan Juan$6K
- Ludemar Roman AcostaSan Juan$5K
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.