Ricardo Fernandez, MD
Internal Medicine · San Juan, PRNPI 1588764013
Payments from drug & device makers
What this record shows
This record is dominated by speaking fees: $313,429 of the $351,027 with a category attached, or 89.3%. 31 manufacturers reported payments, led by Johnson & Johnson at 41.9% of the total. Among internal medicine 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 570 payments — averaging $615.84 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Johnson & Johnson$147K
- AstraZeneca$105K
- Boehringer Ingelheim$71K
- Bayer$17K
- Sanofi$5K
- GSK$2K
- plus $4K from 25 others
Across 39 payments — averaging $4094.78 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.
- Boehringer Ingelheim$73K
- E.r. Squibb & Sons, L.L.C.$43K
- Eli Lilly$31K
- Regeneron$10K
- Boehringer Ingelheim International GmbH$4K
What the payments were for
- Consulting fees$15,1974%
- Speaking & faculty fees$313,42989%
- Travel & lodging$3,7211%
- Food & beverage$18,3455%
- Education$3150%
- Gifts$200%
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 | 122 | $147,240 |
| AstraZeneca | 136 | $105,216 |
| Boehringer Ingelheim | 101 | $71,056 |
| Bayer | 34 | $17,332 |
| Sanofi | 25 | $4,929 |
| GSK | 55 | $1,750 |
| Genentech USA, Inc. | 14 | $575 |
| United Therapeutics Corporation | 9 | $446 |
| Merck | 10 | $360 |
| E.r. Squibb & Sons, L.L.C. | 6 | $250 |
| Mylan Specialty L.p. | 7 | $201 |
| Insmed, Inc. | 4 | $187 |
| AbbVie(2 entities) | 7 | $149 |
| Mallinckrodt Hospital Products Inc. | 3 | $148 |
| Jazz Pharmaceuticals Inc. | 3 | $147 |
| Mylan LLC | 7 | $133 |
| Takeda Pharmaceuticals U.S.A., Inc. | 4 | $115 |
| Actelion Pharmaceuticals US, Inc. | 1 | $112 |
| PBG Puerto Rico LLC | 5 | $105 |
| Novartis | 1 | $94 |
| Edwards Lifesciences | 1 | $90 |
| Medtronic | 1 | $81 |
| Eli Lilly Export S.A. Puerto Rico Branch | 3 | $77 |
| Pfizer | 2 | $52 |
| Chiesi USA, Inc. | 2 | $34 |
| Sanofi-aventis U.S. LLC | 2 | $33 |
| Olympus Latin America, Inc. | 1 | $32 |
| Caris MPI, Inc. | 1 | $25 |
| Amgen | 1 | $23 |
| Shire North American Group Inc | 1 | $20 |
| Viatris Specialty 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.
How this compares
$351,027 in reported general payments places this provider in the 95th percentile of 1,043 internal medicine 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 |
|---|---|---|
| AdempasRiociguat | 47 | $630,912 |
| OfevNintedanib Esylate | 15 | $192,012 |
| Trelegy ElliptaFluticasone/Umeclidin/Vilanter | 171 | $116,256 |
| Fasenra PenBenralizumab | 14 | $80,360 |
| Breo ElliptaFluticasone/Vilanterol | 106 | $44,626 |
| Dupixent SyringeDupilumab | 11 | $42,304 |
| Budesonide-Formoterol FumarateBudesonide/Formoterol Fumarate | 174 | $41,007 |
| SymbicortBudesonide/Formoterol Fumarate | 115 | $28,181 |
| Spiriva RespimatTiotropium Bromide | 38 | $20,982 |
| Breztri AerosphereBudesonide/Glycopyr/Formoterol | 25 | $16,244 |
| Azelastine-FluticasoneAzelastine/Fluticasone | 125 | $13,522 |
| EliquisApixaban | 18 | $10,979 |
| Albuterol Sulfate HfaAlbuterol Sulfate | 257 | $10,653 |
| Fluticasone Propionate | 532 | $10,384 |
| Wixela InhubFluticasone Propion/Salmeterol | 57 | $9,921 |
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 |
|---|---|---|
| BayerAdempas | $17,332 | $630,91247 claims |
| Boehringer IngelheimOfev, Spiriva Respimat, Stiolto Respimat | $71,056 | $218,87565 claims |
| GSKTrelegy Ellipta, Breo Ellipta, Anoro Ellipta | $1,750 | $167,587291 claims |
| AstraZenecaSymbicort, Breztri Aerosphere | $105,216 | $44,426140 claims |
| PfizerEliquis | $52 | $10,97918 claims |
| Johnson & JohnsonXarelto | $147,240 | $7,48113 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 1,043 internal medicine providers in Puerto Rico.
Other internal medicine in San Juan
- Norma SalgadoSan Juan$21K
- Victor Gordo GonzalezSan Juan$21K
- Roberto Calderon SantiagoSan Juan$20K
- Natalia Almodovar ArbeloSan Juan$9K
- Jeremy FelicianoSan Juan$8K
- Porfirio Diaz-RodriguezSan Juan$8K
- Pedro del Valle de TomasSan Juan$7K
- Rafael Figueroa NavarroSan Juan$6K
- Amilcar Torres FigueroaSan Juan$6K
- Hector Leon-FigueroaSan Juan$6K
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.