Ruel Garcia, MD
Pulmonary Disease · Orlando, FLNPI 1629170857
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 94.6% of the total across 198 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 31 manufacturers, the largest accounting for just 17.8% — the pattern of someone who eats at a lot of different presentations. That places this record below the midpoint for pulmonary disease clinicians in FL, where the typical reported total is $2,936.
Across 198 payments — averaging $18.80 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- GSK$664
- Sanofi$362
- Philips North America LLC$352
- Boehringer Ingelheim$349
- AstraZeneca$344
- Actelion Pharmaceuticals US, Inc.$193
- plus $1K from 25 others
Across 5 payments — averaging $1500.00 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.
- Janssen Research & Development, LLC$8K
What the payments were for
- Food & beverage$3,52195%
- Education$1735%
- Gifts$281%
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 | 47 | $664 |
| Sanofi | 17 | $362 |
| Philips North America LLC | 24 | $352 |
| Boehringer Ingelheim | 20 | $349 |
| AstraZeneca | 19 | $344 |
| Actelion Pharmaceuticals US, Inc. | 5 | $193 |
| Regeneron Healthcare Solutions, Inc. | 7 | $174 |
| Bayer | 8 | $173 |
| Insmed, Inc. | 8 | $162 |
| Novartis | 6 | $131 |
| Grifols USA, LLC | 5 | $107 |
| Jazz Pharmaceuticals Inc. | 2 | $89 |
| Mylan Specialty L.p. | 4 | $75 |
| Takeda Pharmaceuticals U.S.A., Inc. | 2 | $60 |
| Viatris Specialty LLC | 2 | $55 |
| Merck | 2 | $53 |
| Gilead | 2 | $46 |
| AbbVie(2 entities) | 2 | $40 |
| Verona Pharma, Inc. | 2 | $39 |
| United Therapeutics Corporation | 2 | $36 |
| Electromed, Inc. | 2 | $32 |
| Advanced Respiratory, Inc | 1 | $28 |
| Vapotherm Inc | 1 | $24 |
| Genentech USA, Inc. | 1 | $19 |
| Phadia US Inc. | 1 | $19 |
| Paratek Pharmaceuticals, Inc. | 1 | $17 |
| Mallinckrodt Hospital Products Inc. | 1 | $17 |
| Pulmonx Corporation | 1 | $16 |
| Portola Pharmaceuticals, LLC | 1 | $16 |
| Pfizer | 1 | $15 |
| Sandoz | 1 | $15 |
How this compares
$3,721 in reported general payments places this provider in the 50th percentile of 953 pulmonary disease 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 |
|---|---|---|
| Orenitram ErTreprostinil Diolamine | 60 | $798,451 |
| UptraviSelexipag | 34 | $733,575 |
| OfevNintedanib Esylate | 50 | $596,190 |
| Trelegy ElliptaFluticasone/Umeclidin/Vilanter | 557 | $557,149 |
| AdempasRiociguat | 36 | $502,302 |
| XolairOmalizumab | 71 | $289,672 |
| OpsumitMacitentan | 17 | $218,178 |
| LetairisAmbrisentan | 14 | $181,053 |
| Dupixent PenDupilumab | 43 | $174,024 |
| Ambrisentan | 45 | $106,164 |
| Breztri AerosphereBudesonide/Glycopyr/Formoterol | 97 | $82,142 |
| Fasenra PenBenralizumab | 11 | $62,080 |
| Anoro ElliptaUmeclidinium Brm/Vilanterol Tr | 79 | $57,760 |
| Pirfenidone | 13 | $57,179 |
| Breo ElliptaFluticasone/Vilanterol | 82 | $51,340 |
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 |
|---|---|---|
| Actelion Pharmaceuticals US, Inc.Uptravi, Opsumit | $193 | $951,75351 claims |
| GSKTrelegy Ellipta, Anoro Ellipta, Breo Ellipta, Arnuity Ellipta, Incruse Ellipta | $664 | $691,520783 claims |
| Boehringer IngelheimOfev, Spiriva Respimat, Stiolto Respimat | $349 | $660,175118 claims |
| BayerAdempas | $173 | $502,30236 claims |
| GileadLetairis | $46 | $181,05314 claims |
| AstraZenecaBreztri Aerosphere, Symbicort | $344 | $131,069236 claims |
| PfizerEliquis | $15 | $13,22624 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 50th percentile of 953 pulmonary disease providers in Florida.
Other pulmonary disease in Orlando
- Ali JiwaniOrlando$859K
- Junaid MalikOrlando$429K
- Franck RahaghiWeston$1.2M
- Michael OttEglin Afb$909K
- Anas HadehWeston$800K
- Jennifer FultonJacksonville$665K
- Ricardo Restrepo-JaramilloTampa$555K
- Mark RumbakTampa$528K
- Jose Soto SotoJacksonville$504K
- Javier Perez FernandezMiami$496K
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.