Stephen Bury Fiol, MD
Internal Medicine · Ponce, PRNPI 1538518501
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 100.0% of the total across 196 separate payments, which is the pattern of a clinician who attends manufacturer presentations rather than one with a consulting arrangement. 19 manufacturers reported payments, led by AstraZeneca at 38.4% of the total. Among internal medicine 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 196 payments — averaging $26.40 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- AstraZeneca$2K
- Johnson & Johnson$656
- PBG Puerto Rico LLC$393
- E.r. Squibb & Sons, L.L.C.$377
- Boehringer Ingelheim$312
- ZOLL Services LLC (a/k/a ZOLL Lifecor Corp)$274
- plus $1K from 13 others
What the payments were for
- Food & beverage$5,175100%
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 |
|---|---|---|
| AstraZeneca | 84 | $1,986 |
| Johnson & Johnson | 21 | $656 |
| PBG Puerto Rico LLC | 18 | $393 |
| E.r. Squibb & Sons, L.L.C. | 9 | $377 |
| Boehringer Ingelheim | 8 | $312 |
| ZOLL Services LLC (a/k/a ZOLL Lifecor Corp) | 17 | $274 |
| Bayer Puerto Rico Inc. | 8 | $195 |
| Dexcom, Inc. | 4 | $194 |
| Boston Scientific | 2 | $156 |
| Lilly USA, LLC | 2 | $144 |
| AbbVie | 5 | $84 |
| Medtronic | 2 | $72 |
| Amgen | 1 | $67 |
| GSK | 4 | $63 |
| Novo Nordisk | 3 | $60 |
| Bayer | 2 | $52 |
| Sanofi-aventis U.S. LLC | 3 | $44 |
| Merck | 2 | $33 |
| Novartis | 1 | $12 |
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.
- WATCHMAN FLX$133
- CAMZYOS$125
- JARDIANCE$125
- DEXCOM G6 TRANSMITTER$114
- AIRSUPRA$113
How this compares
$5,175 in reported general payments places this provider in the 90th 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 |
|---|---|---|
| EliquisApixaban | 156 | $117,873 |
| JardianceEmpagliflozin | 121 | $87,801 |
| FarxigaDapagliflozin Propanediol | 110 | $87,482 |
| TradjentaLinagliptin | 73 | $40,411 |
| BrilintaTicagrelor | 59 | $38,879 |
| Trijardy XrEmpaglifloz/Linaglip/Metformin | 42 | $29,552 |
| SynthroidLevothyroxine Sodium | 353 | $27,150 |
| JanumetSitagliptin Phos/Metformin Hcl | 32 | $25,744 |
| SynjardyEmpagliflozin/Metformin Hcl | 27 | $25,567 |
| EntrestoSacubitril/Valsartan | 31 | $19,640 |
| JentaduetoLinagliptin/Metformin Hcl | 25 | $19,151 |
| GlyxambiEmpagliflozin/Linagliptin | 21 | $16,960 |
| Breo ElliptaFluticasone/Vilanterol | 37 | $16,867 |
| XareltoRivaroxaban | 21 | $15,738 |
| Xigduo XrDapaglifloz Propaned/Metformin | 23 | $13,793 |
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 |
|---|---|---|
| Boehringer IngelheimJardiance, Tradjenta, Trijardy Xr, Synjardy, Jentadueto | $312 | $219,442309 claims |
| AstraZenecaFarxiga, Brilinta | $1,986 | $126,361169 claims |
| MerckJanumet, Januvia | $33 | $37,25147 claims |
| AbbVieSynthroid | $84 | $27,150353 claims |
| NovartisEntresto | $12 | $19,64031 claims |
| GSKBreo Ellipta | $63 | $16,86737 claims |
| Lilly USA, LLCHumalog, Humulin 70-30, Humalog Mix 75-25 | $144 | $16,394132 claims |
| Johnson & JohnsonXarelto | $656 | $15,73821 claims |
| Sanofi-aventis U.S. LLCLantus | $44 | $10,908133 claims |
| BayerKerendia | $52 | $8,80613 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 1,043 internal medicine providers in Puerto Rico.
Other internal medicine in Ponce
- Hector Martinez FornaPonce$19K
- Elizabeth BarrancoPonce$15K
- Enrique Rodriguez-PazPonce$14K
- Carlos RiveraPonce$12K
- Darcy Diago BlancoPonce$10K
- Rafael Espinet PerezPonce$7K
- Brian Torres MercadoPonce$6K
- Raul Cota LeyPonce$6K
- Humberto SimonettiPonce$6K
- Eduardo Colon MelendezPonce$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.