Payment overview · 2025
General Payments
$316.40
16 reported records · 8 companies
Healthcare provider profile · identity verified
Horacio N. Alvarez Ramirez, MD
Allopathic & Osteopathic Physicians|Family Medicine · LINCOLN, NE · NPI 1093155517
Verified facts
What the public records show
CMS Open Payments records show Horacio N. Alvarez Ramirez, MD received $316.40 in general payments during 2025 across 16 reported records.
Novo Nordisk Inc accounted for 30.0% of that reported general-payment amount.
The Open Payments records used for this analysis explicitly named 13 associated products.
A separate comparison found the same explicitly named product in public Medicare Part D data: Ozempic.
AstraZeneca Pharmaceuticals LP reported payments to this doctor in 2025. Across the 2025 Open Payments General Payment records loaded for this analysis, that same reporting entity reported SYMBICORT as an associated drug or biological on 71 records involving 51 distinct recipient NPIs. Public Medicare Part D data also shows 17 claims for Symbicort by this doctor in 2024.
GlaxoSmithKline, LLC. reported payments to this doctor in 2025. Across the 2025 Open Payments General Payment records loaded for this analysis, that same reporting entity reported TRELEGY ELLIPTA as an associated drug or biological on 131532 records involving 37148 distinct recipient NPIs. Public Medicare Part D data also shows 59 claims for Trelegy Ellipta by this doctor in 2024.
Novo Nordisk Inc reported payments to this doctor in 2025. Across the 2025 Open Payments General Payment records loaded for this analysis, that same reporting entity reported Ozempic as an associated drug or biological on 261625 records involving 77793 distinct recipient NPIs. Public Medicare Part D data also shows 70 claims for Ozempic by this doctor in 2024.
These records do not establish that a payment influenced prescribing or medical care.
Separate record types
Research & Ownership
Research Payments (direct recipient): not present in the loaded data
Associated Research Funding (for example, named PI): not present in the loaded data
Ownership / Investment: not present in the loaded data
These categories are never added into the General Payments headline. Associated research funding must not be described as money the doctor personally received unless the source record supports that conclusion.
Who paid this doctor?
Companies in 2025 General Payments
| Reported company | Canonical company | Amount | Share | Records | Year |
|---|---|---|---|---|---|
| Novo Nordisk Inc | Unresolved — no canonical attribution shown | $94.86 | 30.0% | 5 | 2025 |
| Otsuka America Pharmaceutical, Inc. | Unresolved — no canonical attribution shown | $56.97 | 18.0% | 2 | 2025 |
| ABBVIE INC. | Unresolved — no canonical attribution shown | $52.63 | 16.6% | 3 | 2025 |
| ITI, Inc. (d/b/a Intra-Cellular Therapies, Inc.) | Unresolved — no canonical attribution shown | $37.75 | 11.9% | 2 | 2025 |
| Alkermes, Inc. | Unresolved — no canonical attribution shown | $29.47 | 9.3% | 1 | 2025 |
| GlaxoSmithKline, LLC. | Unresolved — no canonical attribution shown | $15.58 | 4.9% | 1 | 2025 |
| AstraZeneca Pharmaceuticals LP | Unresolved — no canonical attribution shown | $14.82 | 4.7% | 1 | 2025 |
| Xeris Pharmaceuticals, Inc. | Unresolved — no canonical attribution shown | $14.32 | 4.5% | 1 | 2025 |
What were the payments for?
Payment categories
| Category | Amount | Records |
|---|---|---|
| Food and Beverage | $316.40 | 16 |
A meal, consulting fee, royalty, and travel payment describe different kinds of reported relationships and should not be interpreted as equivalent.
Analysis 1 · Payment-linked products
Products named in Open Payments records
| Reported product | Type | Reported company | Related amount* | Records | Year |
|---|---|---|---|---|---|
| Ozempic Normalized: ozempic |
Drug | Novo Nordisk Inc | $94.86 | 5 | 2025 |
Source payment records
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| Rybelsus Normalized: rybelsus |
Drug | Novo Nordisk Inc | $80.64 | 4 | 2025 |
Source payment records
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| REXULTI Normalized: rexulti |
Drug | Otsuka America Pharmaceutical, Inc. | $56.97 | 2 | 2025 |
Source payment records
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| CAPLYTA Normalized: caplyta |
Drug | ITI, Inc. (d/b/a Intra-Cellular Therapies, Inc.) | $37.75 | 2 | 2025 |
Source payment records
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| VRAYLAR Normalized: vraylar |
Drug | ABBVIE INC. | $29.69 | 2 | 2025 |
Source payment records
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| VIVITROL Normalized: vivitrol |
Drug | Alkermes, Inc. | $29.47 | 1 | 2025 |
Source payment records
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| QULIPTA Normalized: qulipta |
Drug | ABBVIE INC. | $22.94 | 1 | 2025 |
Source payment records
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| UBRELVY Normalized: ubrelvy |
Drug | ABBVIE INC. | $22.94 | 1 | 2025 |
Source payment records
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| AREXVY Normalized: arexvy |
Biological | GlaxoSmithKline, LLC. | $15.58 | 1 | 2025 |
Source payment records
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| BEXSERO Normalized: bexsero |
Biological | GlaxoSmithKline, LLC. | $15.58 | 1 | 2025 |
Source payment records
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| SHINGRIX Normalized: shingrix |
Biological | GlaxoSmithKline, LLC. | $15.58 | 1 | 2025 |
Source payment records
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| BREZTRI Normalized: breztri |
Drug | AstraZeneca Pharmaceuticals LP | $14.82 | 1 | 2025 |
Source payment records
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| GVOKE HYPOPEN Normalized: gvoke hypopen |
Drug | Xeris Pharmaceuticals, Inc. | $14.32 | 1 | 2025 |
Source payment records
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* Product-associated amounts are non-additive because one payment record may name more than one product.
These products were named on specific Open Payments records. A named product does not show that the payment influenced treatment or prescribing.
Public prescribing for products named in payments
| Open Payments product | Payment year | Part D brand | Part D year | Claims | Match method | Source |
|---|---|---|---|---|---|---|
| Ozempic ozempic |
2025 | Ozempic | 2024 | 70 | exact normalized | Medicare Part D |
The presence of the same drug in both datasets does not show that a payment caused or influenced a prescription.
Analysis 2 · Same-company prescribing overlap
Drugs reported in other payments from the same company that also appear in Medicare Part D
This analysis is independent from products named on this doctor’s individual payment records. A row appears only when the exact Open Payments reporting entity paid this doctor, that same reporting entity reported the drug or biological on at least 10 loaded General Payment records involving at least 2 distinct recipient NPIs, and this doctor has the same non-generic brand in public Part D data. This does not mean the company owns or manufactures the drug.
| Paying company | Payment year | Drug reported by same entity | Open Payments evidence | Part D | Claims | Beneficiaries |
|---|---|---|---|---|---|---|
| AstraZeneca Pharmaceuticals LP Exact reporting entity; no affiliate inference |
2025 | SYMBICORT open payments reported associated product |
CMS Open Payments — General Payments 71 supporting records · 51 recipient NPIs · example record 1206132610 |
Symbicort · 2024 Exact normalized brand match · 1 Part D row |
17 | suppressed by CMS |
| GlaxoSmithKline, LLC. Exact reporting entity; no affiliate inference |
2025 | TRELEGY ELLIPTA open payments reported associated product |
CMS Open Payments — General Payments 131532 supporting records · 37148 recipient NPIs · example record 1190332369 |
Trelegy Ellipta · 2024 Exact normalized brand match · 1 Part D row |
59 | suppressed by CMS |
| Novo Nordisk Inc Exact reporting entity; no affiliate inference |
2025 | Ozempic open payments reported associated product |
CMS Open Payments — General Payments 261625 supporting records · 77793 recipient NPIs · example record 1188130076 |
Ozempic · 2024 Exact normalized brand match · 1 Part D row |
70 | 12 |
These facts do not show that a payment was for the drug, that the company owns or manufactures the drug, or that a payment caused or influenced prescribing.
Public Medicare Part D data
Provider-and-drug rows loaded for 2024
| Brand | Generic | Claims | Beneficiaries |
|---|---|---|---|
| Atorvastatin Calcium | Atorvastatin Calcium | 319 | 70 |
| Lisinopril | Lisinopril | 226 | 46 |
| Amlodipine Besylate | Amlodipine Besylate | 190 | 44 |
| Metformin Hcl | Metformin Hcl | 169 | 33 |
| Gabapentin | Gabapentin | 112 | 21 |
| Losartan Potassium | Losartan Potassium | 105 | 32 |
| Omeprazole | Omeprazole | 100 | 22 |
| Levothyroxine Sodium | Levothyroxine Sodium | 95 | 19 |
| Albuterol Sulfate Hfa | Albuterol Sulfate | 86 | 23 |
| Jardiance | Empagliflozin | 82 | 14 |
| Hydrochlorothiazide | Hydrochlorothiazide | 74 | 12 |
| Tamsulosin Hcl | Tamsulosin Hcl | 74 | 12 |
| Carvedilol | Carvedilol | 71 | 14 |
| Fluticasone Propionate | Fluticasone Propionate | 71 | 23 |
| Ozempic | Semaglutide | 70 | 12 |
| Metoprolol Succinate | Metoprolol Succinate | 65 | 12 |
| Metoprolol Tartrate | Metoprolol Tartrate | 60 | 12 |
| Trelegy Ellipta | Fluticasone/Umeclidin/Vilanter | 59 | suppressed |
| Meloxicam | Meloxicam | 54 | 14 |
| Pantoprazole Sodium | Pantoprazole Sodium | 53 | suppressed |
| Furosemide | Furosemide | 51 | 11 |
| Sertraline Hcl | Sertraline Hcl | 50 | 11 |
| Tramadol Hcl | Tramadol Hcl | 49 | suppressed |
| Metformin Hcl Er | Metformin Hcl | 47 | suppressed |
| Lantus Solostar | Insulin Glargine,hum.Rec.Anlog | 41 | suppressed |
| Cyclobenzaprine Hcl | Cyclobenzaprine Hcl | 40 | 12 |
| Pravastatin Sodium | Pravastatin Sodium | 38 | suppressed |
| Simvastatin | Simvastatin | 33 | suppressed |
| Allopurinol | Allopurinol | 32 | suppressed |
| Fenofibrate | Fenofibrate Nanocrystallized | 32 | suppressed |
| Potassium Chloride | Potassium Chloride | 30 | suppressed |
| Trazodone Hcl | Trazodone Hcl | 30 | suppressed |
| Levetiracetam | Levetiracetam | 29 | suppressed |
| Glipizide | Glipizide | 28 | suppressed |
| Lovastatin | Lovastatin | 28 | suppressed |
| Zolpidem Tartrate | Zolpidem Tartrate | 27 | suppressed |
| Lorazepam | Lorazepam | 26 | suppressed |
| Pregabalin | Pregabalin | 26 | suppressed |
| Combivent Respimat | Ipratropium/Albuterol Sulfate | 25 | suppressed |
| Duloxetine Hcl | Duloxetine Hcl | 24 | suppressed |
| Methocarbamol | Methocarbamol | 24 | suppressed |
| Tizanidine Hcl | Tizanidine Hcl | 22 | suppressed |
| Glimepiride | Glimepiride | 21 | suppressed |
| Alendronate Sodium | Alendronate Sodium | 20 | suppressed |
| Rosuvastatin Calcium | Rosuvastatin Calcium | 20 | suppressed |
| Trulicity | Dulaglutide | 19 | suppressed |
| Hydroxyzine Hcl | Hydroxyzine Hcl | 18 | suppressed |
| Pioglitazone Hcl | Pioglitazone Hcl | 18 | suppressed |
| Clopidogrel | Clopidogrel Bisulfate | 17 | suppressed |
| Famotidine | Famotidine | 17 | suppressed |
| Oxycodone Hcl | Oxycodone Hcl | 17 | suppressed |
| Symbicort | Budesonide/Formoterol Fumarate | 17 | suppressed |
| Clonidine Hcl | Clonidine Hcl | 16 | suppressed |
| Escitalopram Oxalate | Escitalopram Oxalate | 16 | suppressed |
| Fluoxetine Hcl | Fluoxetine Hcl | 16 | suppressed |
| Isosorbide Mononitrate Er | Isosorbide Mononitrate | 16 | suppressed |
| Topiramate | Topiramate | 16 | suppressed |
| Verapamil Er | Verapamil Hcl | 16 | suppressed |
| Humalog Mix 75-25 Kwikpen | Insulin Lispro Protamin/Lispro | 15 | suppressed |
| Naproxen | Naproxen | 15 | suppressed |
| Valacyclovir | Valacyclovir Hcl | 15 | suppressed |
| Venlafaxine Hcl Er | Venlafaxine Hcl | 15 | suppressed |
| Ventolin Hfa | Albuterol Sulfate | 15 | suppressed |
| Celecoxib | Celecoxib | 14 | suppressed |
| Easy Touch Alcohol Prep Pads | Alcohol Antiseptic Pads | 14 | suppressed |
| Hydrocodone-Acetaminophen | Hydrocodone/Acetaminophen | 14 | suppressed |
| Quetiapine Fumarate | Quetiapine Fumarate | 14 | suppressed |
| Tresiba Flextouch U-100 | Insulin Degludec | 14 | suppressed |
| Alprazolam | Alprazolam | 13 | suppressed |
| Amitriptyline Hcl | Amitriptyline Hcl | 13 | suppressed |
| Breo Ellipta | Fluticasone/Vilanterol | 13 | suppressed |
| Buspirone Hcl | Buspirone Hcl | 13 | suppressed |
| Insulin Lispro Kwikpen U-100 | Insulin Lispro | 13 | suppressed |
| Lisinopril-Hydrochlorothiazide | Lisinopril/Hydrochlorothiazide | 13 | suppressed |
| Nano 2nd Gen Pen Needle | Pen Needle, Diabetic | 13 | suppressed |
| Xarelto | Rivaroxaban | 13 | suppressed |
| Fenofibrate | Fenofibrate | 12 | suppressed |
| Humalog Kwikpen U-100 | Insulin Lispro | 11 | suppressed |
| Novolog Flexpen | Insulin Aspart | 11 | suppressed |
| Oxycodone-Acetaminophen | Oxycodone Hcl/Acetaminophen | 11 | suppressed |
| Ropinirole Hcl | Ropinirole Hcl | 11 | suppressed |
| Ultra-Fine Nano Pen Needle | Pen Needle, Diabetic | 11 | suppressed |
| Ultra-Fine Short Pen Needle | Pen Needle, Diabetic | 11 | suppressed |
Timeline
Payment and prescribing data by year
Open Payments and Medicare Part D may refer to different years. They are shown separately rather than aligned as if they describe the same period.
| Year | General Payments | Main payer | Explicit products | Company overlaps | Part D coverage |
|---|---|---|---|---|---|
| 2025 | $316.40 · 16 records | Novo Nordisk Inc | AREXVY, BEXSERO, BREZTRI, CAPLYTA, GVOKE HYPOPEN, Ozempic, QULIPTA, REXULTI, Rybelsus, SHINGRIX, UBRELVY, VIVITROL, VRAYLAR | 3 | — |
| 2024 | — | — | — | — | Complete |
Questions to ask
Questions you could discuss with your doctor
- What role, if any, does Ozempic play in your treatment recommendations for me?
- How do you evaluate evidence when you have a financial relationship with AstraZeneca Pharmaceuticals LP?
- Are there reasonable alternatives I should understand when we discuss treatment options?
- How should I interpret the industry-payment records shown here in the context of my care?
These are general questions generated from reviewed templates. They are not personalized medical advice.
Sources and limitations
How to read this page
- Payment and Medicare prescribing data can cover different years; every comparison shows both years explicitly.
- Part D does not represent a doctor’s entire practice; it excludes many patients and is subject to CMS public-release thresholds.
- Company–drug relationships must have an auditable source, a precise relationship type, and a valid evidence period. Unresolved mappings are not published.
- Generic drug claims are not attributed to a specific manufacturer without manufacturer-level evidence.
- When a source extract is incomplete, missing rows are never treated as proof of no payments or no prescriptions.
Loaded source releases
| Dataset | Year | Publication | Source |
|---|---|---|---|
| CMS Open Payments — General Payments | 2025 | 2026-06-30 | Original source |
| Medicare Part D Prescribers by Provider and Drug | 2024 | 2026-05-06 | Original source |
| NPPES Data Dissemination V2 | current / reference data | 2026-08-10 | Original source |
Full methodology · Questions & answers · Report a possible error