Robert Ramirez, MD
Allergy & Immunology · San Antonio, TXNPI 1063512713
Payments from drug & device makers
Across 776 payments — averaging $724.64 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- GSK$319K
- AstraZeneca$130K
- Sanofi$103K
- Novartis$2K
- Regeneron Healthcare Solutions, Inc.$2K
- Sanofi-aventis U.S. LLC$759
- plus $6K from 30 others
Across 27 payments — averaging $134.88 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.
- GSK$2K
- Sanofi US Services Inc.$1K
What the payments were for
- Consulting fees$1,4465%
- Speaking & faculty fees$8,45026%
- Travel & lodging$2,1327%
- Food & beverage$19,72762%
- Education$1420%
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 |
|---|---|---|
| GSK | 284 | $318,815 |
| AstraZeneca | 76 | $129,701 |
| Sanofi | 58 | $102,656 |
| Novartis | 31 | $2,125 |
| Regeneron Healthcare Solutions, Inc. | 73 | $2,119 |
| Sanofi-aventis U.S. LLC | 35 | $759 |
| Genentech USA, Inc. | 24 | $622 |
| Alk-abello, Inc | 25 | $515 |
| Optinose US, Inc. | 23 | $503 |
| Amgen | 20 | $501 |
| CSL Behring | 19 | $420 |
| Incyte Corporation | 7 | $372 |
| Genentech, Inc. | 4 | $323 |
| Boehringer Ingelheim | 13 | $300 |
| Kaleo, Inc. | 14 | $290 |
| ARS Pharmaceuticals Operations, Inc. | 11 | $289 |
| Regeneron | 3 | $240 |
| Pfizer | 2 | $222 |
| Sunovion Pharmaceuticals Inc. | 7 | $195 |
| Aimmune Therapeutics, Inc. | 5 | $154 |
| Takeda Pharmaceuticals U.S.A., Inc. | 6 | $140 |
| Biohaven Pharmaceutical Holding Company Ltd. | 1 | $125 |
| Shire North American Group Inc | 1 | $122 |
| Octapharma USA, Inc. | 4 | $118 |
| Blueprint Medicines Corporation | 1 | $114 |
| Grifols USA, LLC | 6 | $98 |
| Pharming Healthcare, Inc. | 4 | $91 |
| Galderma Laboratories, L.p. | 4 | $85 |
| Ionis Pharmaceuticals, Inc. | 3 | $82 |
| Teva Pharmaceuticals USA, Inc. | 3 | $61 |
| Verona Pharma, Inc. | 2 | $33 |
| Organon | 2 | $32 |
| Mylan Specialty L.p. | 2 | $31 |
| Greer Laboratories, Inc. | 1 | $30 |
| Jubilant Hollisterstier LLC | 1 | $24 |
| Sanofi Pasteur Inc. | 1 | $13 |
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
$562,318 in reported general payments places this provider in the 95th percentile of 336 allergy & immunology providers in Texas.
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 |
|---|---|---|
| Trelegy ElliptaFluticasone/Umeclidin/Vilanter | 77 | $64,117 |
| Breo ElliptaFluticasone/Vilanterol | 35 | $21,506 |
| Breztri AerosphereBudesonide/Glycopyr/Formoterol | 22 | $17,262 |
| Spiriva RespimatTiotropium Bromide | 19 | $10,668 |
| Qvar RedihalerBeclomethasone Dipropionate | 12 | $8,770 |
| Advair HfaFluticasone Propion/Salmeterol | 19 | $8,294 |
| Arnuity ElliptaFluticasone Furoate | 26 | $7,425 |
| Azelastine Hcl | 232 | $6,577 |
| SymbicortBudesonide/Formoterol Fumarate | 14 | $4,630 |
| Fluticasone-SalmeterolFluticasone Propion/Salmeterol | 32 | $4,003 |
| Budesonide-Formoterol FumarateBudesonide/Formoterol Fumarate | 21 | $3,933 |
| Fluticasone Propionate | 199 | $2,589 |
| Albuterol Sulfate HfaAlbuterol Sulfate | 80 | $2,164 |
| Ipratropium Bromide | 57 | $2,076 |
| Ventolin HfaAlbuterol Sulfate | 18 | $965 |
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 |
|---|---|---|
| GSKTrelegy Ellipta, Breo Ellipta, Arnuity Ellipta | $318,815 | $93,048138 claims |
| AstraZenecaBreztri Aerosphere, Symbicort | $129,701 | $21,89236 claims |
| Boehringer IngelheimSpiriva Respimat | $300 | $10,66819 claims |
| Teva Pharmaceuticals USA, Inc.Qvar Redihaler | $61 | $8,77012 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 336 allergy & immunology providers in Texas.
Other allergy & immunology in San Antonio
- Erika GonzalezSan Antonio$2.2M
- Joseph DiazSan Antonio$1.8M
- Robert JacobsSan Antonio$757K
- Lukena KarkhanisSan Antonio$377K
- John DiceSan Antonio$188K
- Araceli ElizaldeSan Antonio$51K
- Mark StahlSan Antonio$51K
- William HowlandAustin$3.6M
- Russell PerryBeaumont$3.2M
- Barbara BaxterDallas$2.5M
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.