Roberto Alvarez Swihart, MD
Rheumatology · Aibonito, PRNPI 1225071467
Payments from drug & device makers
What this record shows
This record is dominated by speaking fees: $12,320 of the $20,215 with a category attached, or 60.9%. Amgen accounts for 65.8% of it on its own, with 13 other manufacturers making up the rest. Reporting peaked in 2019 at $11,306 and has fallen 76.3% since, to $2,678 in 2025. Among rheumatology clinicians in PR with any reported payments, this total sits in the top 10% — high for the specialty, which is a reason to read the composition above rather than the number alone.
Across 218 payments — averaging $92.73 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Amgen$13K
- AbbVie$5K
- Novartis$536
- E.r. Squibb & Sons, L.L.C.$302
- Organon$207
- PBG Puerto Rico LLC$188
- plus $730 from 8 others
What the payments were for
- Consulting fees$1,7259%
- Speaking & faculty fees$12,32061%
- Travel & lodging$1,6408%
- Food & beverage$4,44222%
- Education$880%
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 | 63 | $13,301 |
| AbbVie | 58 | $4,952 |
| Novartis | 31 | $536 |
| E.r. Squibb & Sons, L.L.C. | 21 | $302 |
| Organon | 9 | $207 |
| PBG Puerto Rico LLC | 9 | $188 |
| AstraZeneca | 8 | $152 |
| GSK | 2 | $127 |
| Pfizer | 1 | $125 |
| Eli Lilly Export S.A. Puerto Rico Branch | 5 | $108 |
| Radius Health, Inc. | 4 | $101 |
| Hikma Pharmaceuticals USA | 4 | $83 |
| Boehringer Ingelheim | 1 | $19 |
| Pfizer Pharmaceuticals LLC | 2 | $14 |
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.
- Enbrel$12,115
- Rinvoq$3,254
- PREVNAR - 13$125
- BENLYSTA$112
How this compares
$20,215 in reported general payments places this provider in the 90th 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 |
|---|---|---|
| RinvoqUpadacitinib | 191 | $1,229,466 |
| Enbrel SureclickEtanercept | 146 | $1,068,790 |
| Humira(Cf) PenAdalimumab | 130 | $1,040,755 |
| Humira(Cf)Adalimumab | 148 | $1,031,014 |
| EnbrelEtanercept | 126 | $936,511 |
| OrenciaAbatacept | 60 | $344,340 |
| Xeljanz XrTofacitinib Citrate | 57 | $328,504 |
| Hadlima(Cf) PushtouchAdalimumab-Bwwd | 283 | $295,131 |
| Cosentyx Unoready PenSecukinumab | 36 | $290,981 |
| Enbrel MiniEtanercept | 30 | $228,495 |
| Orencia ClickjectAbatacept | 40 | $227,945 |
| ProliaDenosumab | 112 | $201,164 |
| BenlystaBelimumab | 40 | $191,681 |
| Cyltezo(Cf) PenAdalimumab-Adbm | 24 | $156,532 |
| Cyltezo(Cf)Adalimumab-Adbm | 13 | $85,165 |
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 |
|---|---|---|
| AbbVieRinvoq, Humira(Cf), Savella, Synthroid | $4,952 | $2,292,608642 claims |
| AmgenEnbrel, Prolia, Evenity (2 Syringes) | $13,301 | $1,181,913256 claims |
| E.r. Squibb & Sons, L.L.C.Orencia | $302 | $344,34060 claims |
| GSKBenlysta | $127 | $191,68140 claims |
| Boehringer IngelheimCyltezo(Cf) | $19 | $85,16513 claims |
| NovartisCosentyx (2 Syringes) | $536 | $81,91411 claims |
| OrganonHadlima(Cf) | $207 | $37,18736 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 88 rheumatology providers in Puerto Rico.
Other rheumatology in Aibonito
- 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
- Amarilis Perez de JesusCaguas$18K
- Roberto Leon-PerezPonce$17K
- Sonialy Lugo RuizAguadilla$17K
- Anaida Nadal TorresGuayama$16K
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.