NATALIE HOWLETT
Prescription History 1154776094
Internal Medicine in Palo Alto, CA


Quality Rating: 80.58 out of 100 score

NPI Status: Active since April 28, 2016

Contact Information

900 BLAKE WILBUR DR
PALO ALTO, CA
ZIP 94304
Phone: (650) 723-6961

Get Directions

Prescription History for Informed Healthcare Decisions

Explore the verified Medicare Part D prescription history, volume metrics, and calculated drug costs for NATALIE HOWLETT, an active Internal Medicine specialist practicing in Palo Alto, CA. Our medical registry currently tracks 29 unique pharmaceutical formulations prescribed by this provider, representing an estimated volume of 820 documented patient claims. Among these therapy options, the most frequently utilized medication is Methotrexate, which accounts for 78 claims alone.


Actemra Actpen

Generic Formulation: TocilizumabSpecialty: Internal Medicine
Provider Metrics Summary
Total Claims 13
30-Day Fills 15.6
Days Supply 448
CA State Average Benchmarks
Peer Average Claims20.0
Peer Average 30-Day Fills21.1
Peer Average Days Supply574
Conservative Utilization

This provider writes prescriptions for this formulation 35.0% less frequently than the standard regional baseline metric for practitioners inside CA. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $63,153.55 across this reporting matrix range.

Provider Avg Cost Per Claim

$4,857.97

State Avg Cost Per Claim

$3,460.87

Note on Expenses: These indicators represent gross infrastructure resource tracking paid directly to supply pharmacy networks by Medicare Part D configurations. These calculations do not track individual patient insurance tier copays or out-of-pocket shelf prices at retail checkout lanes.

Therapeutic Applications

This medication is used to treat rheumatoid arthritis in adults and in children (such as systemic juvenile idiopathic arthritis-SJIA, polyarticular juvenile idiopathic arthritis-PJIA). It helps to reduce pain and swelling due to rheumatoid arthritis. Tocilizumab can also be used to treat giant cell arteritis. It helps to reduce swelling in your blood vessels so blood can flow more easily. Tocilizumab may also be used to treat a reaction (Cytokine Release Syndrome-CRS) caused by certain cancer treatments. Tocilizumab belongs to a class of drugs known as Interleukin-6 (IL-6) blockers. It works by blocking IL-6, a substance made by the body that causes swelling (inflammation). Tocilizumab is used in combination with a corticosteroid (such as dexamethasone) to treat coronavirus disease (COVID-19) in hospitalized patients who need supplemental oxygen (including patients on a mechanical ventilator). The FDA is allowing tocilizumab to be used to treat coronavirus disease in human studies and for emergency use. Tocilizumab is approved to be used in Canada to treat coronavirus disease. If tocilizumab is used to treat coronavirus disease, more information about the drug is available from the patient information sheet provided by your health care professional. If you are enrolled in a study, information should be provided by the doctor via the Informed Consent Form.

Alendronate Sodium

Generic Formulation: Alendronate SodiumSpecialty: Internal Medicine
Provider Metrics Summary
Total Claims 15
30-Day Fills 42.0
Days Supply 1,260
CA State Average Benchmarks
Peer Average Claims58.0
Peer Average 30-Day Fills138.0
Peer Average Days Supply4,109
Highly Conservative Utilization

This provider demonstrates a highly selective approach to this formula, recording 74.1% less volume than the regional standard for practitioners inside CA. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $457.53 across this reporting matrix range.

Provider Avg Cost Per Claim

$30.50

State Avg Cost Per Claim

$12.46

Note on Expenses: These indicators represent gross infrastructure resource tracking paid directly to supply pharmacy networks by Medicare Part D configurations. These calculations do not track individual patient insurance tier copays or out-of-pocket shelf prices at retail checkout lanes.

Clinical Summary

A nonhormonal medication for the treatment of postmenopausal osteoporosis in women. This drug builds healthy bone, restoring some of the bone loss as a result of osteoporosis.

Therapeutic Applications

Alendronate is used to prevent and treat certain types of bone loss (osteoporosis) in adults. Osteoporosis causes bones to become thinner and break more easily. Your chance of developing osteoporosis increases as you age, after menopause, or if you are taking corticosteroid medications (such as prednisone) for a long time. This medication works by slowing bone loss. This effect helps maintain strong bones and reduce the risk of broken bones (fractures). Alendronate belongs to a class of drugs called bisphosphonates.

Allopurinol

Generic Formulation: AllopurinolSpecialty: Internal Medicine
Provider Metrics Summary
Total Claims 49
30-Day Fills 137.0
Days Supply 4,095
CA State Average Benchmarks
Peer Average Claims44.0
Peer Average 30-Day Fills110.3
Peer Average Days Supply3,283
Standard Average Utilization

This provider's prescribing patterns for this therapeutic formulation sit directly in line with standard baseline averages across CA. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $1,212.04 across this reporting matrix range.

Provider Avg Cost Per Claim

$24.74

State Avg Cost Per Claim

$15.90

Note on Expenses: These indicators represent gross infrastructure resource tracking paid directly to supply pharmacy networks by Medicare Part D configurations. These calculations do not track individual patient insurance tier copays or out-of-pocket shelf prices at retail checkout lanes.

Clinical Summary

A XANTHINE OXIDASE inhibitor that decreases URIC ACID production. It also acts as an antimetabolite on some simpler organisms.

Therapeutic Applications

Allopurinol is used to treat gout and certain types of kidney stones. It is also used to prevent increased uric acid levels in patients receiving cancer chemotherapy. These patients can have increased uric acid levels due to release of uric acid from the dying cancer cells. Allopurinol works by reducing the amount of uric acid made by the body. Increased uric acid levels can cause gout and kidney problems.

Amitriptyline Hcl

Generic Formulation: Amitriptyline HclSpecialty: Internal Medicine
Provider Metrics Summary
Total Claims 16
30-Day Fills 20.0
Days Supply 525
CA State Average Benchmarks
Peer Average Claims24.0
Peer Average 30-Day Fills42.1
Peer Average Days Supply1,246
Conservative Utilization

This provider writes prescriptions for this formulation 33.3% less frequently than the standard regional baseline metric for practitioners inside CA. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $157.36 across this reporting matrix range.

Provider Avg Cost Per Claim

$9.84

State Avg Cost Per Claim

$22.47

Note on Expenses: These indicators represent gross infrastructure resource tracking paid directly to supply pharmacy networks by Medicare Part D configurations. These calculations do not track individual patient insurance tier copays or out-of-pocket shelf prices at retail checkout lanes.

Therapeutic Applications

This medication is used to treat mental/mood problems such as depression. It may help improve mood and feelings of well-being, relieve anxiety and tension, help you sleep better, and increase your energy level. This medication belongs to a class of medications called tricyclic antidepressants. It works by affecting the balance of certain natural chemicals (neurotransmitters such as serotonin) in the brain.

Azathioprine

Generic Formulation: AzathioprineSpecialty: Internal Medicine
Provider Metrics Summary
Total Claims 18
30-Day Fills 48.0
Days Supply 1,440
CA State Average Benchmarks
Peer Average Claims24.0
Peer Average 30-Day Fills51.1
Peer Average Days Supply1,523
Standard Average Utilization

This provider's prescribing patterns for this therapeutic formulation sit directly in line with standard baseline averages across CA. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $1,939.68 across this reporting matrix range.

Provider Avg Cost Per Claim

$107.76

State Avg Cost Per Claim

$66.05

Note on Expenses: These indicators represent gross infrastructure resource tracking paid directly to supply pharmacy networks by Medicare Part D configurations. These calculations do not track individual patient insurance tier copays or out-of-pocket shelf prices at retail checkout lanes.

Clinical Summary

An immunosuppressive agent used in combination with cyclophosphamide and hydroxychloroquine in the treatment of rheumatoid arthritis. According to the Fourth Annual Report on Carcinogens (NTP 85-002, 1985), this substance has been listed as a known carcinogen. (Merck Index, 11th ed)

Therapeutic Applications

Azathioprine is used to prevent organ rejection in people who have received a kidney transplant. It is usually taken along with other medications to allow your new kidney to function normally. Azathioprine is also used to treat rheumatoid arthritis. In this condition, the body's defense system (immune system) attacks healthy joints. Azathioprine belongs to a class of drugs known as immunosuppressants. It works by weakening the immune system to help your body accept the new kidney as if it were your own (in the case of an organ transplant) or to prevent further damage to your joints (in the case of rheumatoid arthritis). Talk to your doctor about the risks and benefits of azathioprine, especially when used by children and young adults.

Baclofen

Generic Formulation: BaclofenSpecialty: Internal Medicine
Provider Metrics Summary
Total Claims 14
30-Day Fills 16.0
Days Supply 460
CA State Average Benchmarks
Peer Average Claims41.0
Peer Average 30-Day Fills55.0
Peer Average Days Supply1,497
Highly Conservative Utilization

This provider demonstrates a highly selective approach to this formula, recording 65.9% less volume than the regional standard for practitioners inside CA. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $570.97 across this reporting matrix range.

Provider Avg Cost Per Claim

$40.78

State Avg Cost Per Claim

$28.61

Note on Expenses: These indicators represent gross infrastructure resource tracking paid directly to supply pharmacy networks by Medicare Part D configurations. These calculations do not track individual patient insurance tier copays or out-of-pocket shelf prices at retail checkout lanes.

Clinical Summary

A GAMMA-AMINOBUTYRIC ACID derivative that is a specific agonist of GABA-B RECEPTORS. It is used in the treatment of MUSCLE SPASTICITY, especially that due to SPINAL CORD INJURIES. Its therapeutic effects result from actions at spinal and supraspinal sites, generally the reduction of excitatory transmission.

Therapeutic Applications

Baclofen is used to treat muscle spasms caused by certain conditions (such as multiple sclerosis, spinal cord injury/disease). It works by helping to relax the muscles.

Benlysta

Generic Formulation: BelimumabSpecialty: Internal Medicine
Provider Metrics Summary
Total Claims 12
30-Day Fills 12.0
Days Supply 336
CA State Average Benchmarks
Peer Average Claims24.0
Peer Average 30-Day Fills24.8
Peer Average Days Supply693
Conservative Utilization

This provider writes prescriptions for this formulation 50.0% less frequently than the standard regional baseline metric for practitioners inside CA. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $55,643.81 across this reporting matrix range.

Provider Avg Cost Per Claim

$4,636.98

State Avg Cost Per Claim

$4,230.25

Note on Expenses: These indicators represent gross infrastructure resource tracking paid directly to supply pharmacy networks by Medicare Part D configurations. These calculations do not track individual patient insurance tier copays or out-of-pocket shelf prices at retail checkout lanes.

Therapeutic Applications

This medication is used with other medications to treat certain types of lupus. Belimumab belongs to a class of drugs known as monoclonal antibodies. It works by decreasing the effect of a certain protein that is increased in people with active lupus. This may help decrease some of the symptoms of lupus.

Colchicine

Generic Formulation: ColchicineSpecialty: Internal Medicine
Provider Metrics Summary
Total Claims 15
30-Day Fills 39.0
Days Supply 1,155
CA State Average Benchmarks
Peer Average Claims23.0
Peer Average 30-Day Fills32.6
Peer Average Days Supply841
Conservative Utilization

This provider writes prescriptions for this formulation 34.8% less frequently than the standard regional baseline metric for practitioners inside CA. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $2,349.37 across this reporting matrix range.

Provider Avg Cost Per Claim

$156.62

State Avg Cost Per Claim

$110.12

Note on Expenses: These indicators represent gross infrastructure resource tracking paid directly to supply pharmacy networks by Medicare Part D configurations. These calculations do not track individual patient insurance tier copays or out-of-pocket shelf prices at retail checkout lanes.

Clinical Summary

A major alkaloid from Colchicum autumnale L. and found also in other Colchicum species. Its primary therapeutic use is in the treatment of gout, but it has been used also in the therapy of familial Mediterranean fever (PERIODIC DISEASE).

Therapeutic Applications

This medication is used to prevent or treat gout attacks (flares). Usually gout symptoms develop suddenly and involve only one or a few joints. The big toe, knee, or ankle joints are most often affected. Gout is caused by too much uric acid in the blood. When uric acid levels in the blood are too high, the uric acid may form hard crystals in your joints. Colchicine works by decreasing swelling and lessening the build up of uric acid crystals that cause pain in the affected joint(s). This medication is also used to prevent attacks of pain in the abdomen, chest, or joints caused by a certain inherited disease (familial Mediterranean fever). It is thought to work by decreasing your body's production of a certain protein (amyloid A) that builds up in people with familial Mediterranean fever. Colchicine is not a pain medication and should not be used to relieve other causes of pain.

Diclofenac Sodium

Generic Formulation: Diclofenac SodiumSpecialty: Internal Medicine
Provider Metrics Summary
Total Claims 68
30-Day Fills 102.8
Days Supply 2,952
CA State Average Benchmarks
Peer Average Claims55.0
Peer Average 30-Day Fills62.5
Peer Average Days Supply1,502
Standard Average Utilization

This provider's prescribing patterns for this therapeutic formulation sit directly in line with standard baseline averages across CA. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $4,419.18 across this reporting matrix range.

Provider Avg Cost Per Claim

$64.99

State Avg Cost Per Claim

$41.99

Note on Expenses: These indicators represent gross infrastructure resource tracking paid directly to supply pharmacy networks by Medicare Part D configurations. These calculations do not track individual patient insurance tier copays or out-of-pocket shelf prices at retail checkout lanes.

Clinical Summary

A non-steroidal anti-inflammatory agent (NSAID) with antipyretic and analgesic actions. It is primarily available as the sodium salt.

Therapeutic Applications

See also Warning section. This medication is used to relieve joint pain from arthritis. Diclofenac belongs to a class of drugs known as nonsteroidal anti-inflammatory drugs (NSAIDs). If you are treating a chronic condition such as arthritis, ask your doctor about non-drug treatments and/or using other medications to treat your pain.

Enbrel

Generic Formulation: EtanerceptSpecialty: Internal Medicine
Provider Metrics Summary
Total Claims 39
30-Day Fills 39.0
Days Supply 1,092
CA State Average Benchmarks
Peer Average Claims29.0
Peer Average 30-Day Fills31.6
Peer Average Days Supply889
Elevated Utilization

This provider maintains an active emphasis on this therapeutic option, recording 34.5% more claims than the standard regional baseline profile for CA. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $285,990.30 across this reporting matrix range.

Provider Avg Cost Per Claim

$7,333.08

State Avg Cost Per Claim

$6,514.66

Note on Expenses: These indicators represent gross infrastructure resource tracking paid directly to supply pharmacy networks by Medicare Part D configurations. These calculations do not track individual patient insurance tier copays or out-of-pocket shelf prices at retail checkout lanes.

Clinical Summary

A recombinant version of soluble human TNF receptor fused to an IgG FC fragment that binds specifically to TUMOR NECROSIS FACTOR and inhibits its binding with endogenous TNF receptors. It prevents the inflammatory effect of TNF and is used to treat RHEUMATOID ARTHRITIS; PSORIATIC ARTHRITIS and ANKYLOSING SPONDYLITIS.

Therapeutic Applications

This medication is used alone or in combination with an immunosuppressant (such as methotrexate) to treat certain types of arthritis (such as rheumatoid, psoriatic, juvenile idiopathic, and ankylosing spondylitis). Some brands of this medication are also used to treat a skin condition called psoriasis. These conditions are caused by an overactive immune system (autoimmune disease). The immune system attacks the body's own healthy cells, causing inflammation in the joints and skin. Etanercept controls your body's defensive response by blocking the action of a certain natural substance (TNF) that is used by the immune system. Treatment decreases redness, itching and scaly patches in psoriasis as well as the pain, swelling and stiffness of joints in arthritis. This medication can stop the progression of disease and joint damage, resulting in improved daily functioning and quality of life. This medication treats but does not cure autoimmune diseases. Symptoms usually return within 1 month of stopping the medication.

Enbrel Sureclick

Generic Formulation: EtanerceptSpecialty: Internal Medicine
Provider Metrics Summary
Total Claims 54
30-Day Fills 54.0
Days Supply 1,512
CA State Average Benchmarks
Peer Average Claims42.0
Peer Average 30-Day Fills44.7
Peer Average Days Supply1,262
Elevated Utilization

This provider maintains an active emphasis on this therapeutic option, recording 28.6% more claims than the standard regional baseline profile for CA. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $384,310.28 across this reporting matrix range.

Provider Avg Cost Per Claim

$7,116.86

State Avg Cost Per Claim

$6,763.75

Note on Expenses: These indicators represent gross infrastructure resource tracking paid directly to supply pharmacy networks by Medicare Part D configurations. These calculations do not track individual patient insurance tier copays or out-of-pocket shelf prices at retail checkout lanes.

Clinical Summary

A recombinant version of soluble human TNF receptor fused to an IgG FC fragment that binds specifically to TUMOR NECROSIS FACTOR and inhibits its binding with endogenous TNF receptors. It prevents the inflammatory effect of TNF and is used to treat RHEUMATOID ARTHRITIS; PSORIATIC ARTHRITIS and ANKYLOSING SPONDYLITIS.

Therapeutic Applications

This medication is used alone or in combination with an immunosuppressant (such as methotrexate) to treat certain types of arthritis (such as rheumatoid, psoriatic, juvenile idiopathic, and ankylosing spondylitis). Some brands of this medication are also used to treat a skin condition called psoriasis. These conditions are caused by an overactive immune system (autoimmune disease). The immune system attacks the body's own healthy cells, causing inflammation in the joints and skin. Etanercept controls your body's defensive response by blocking the action of a certain natural substance (TNF) that is used by the immune system. Treatment decreases redness, itching and scaly patches in psoriasis as well as the pain, swelling and stiffness of joints in arthritis. This medication can stop the progression of disease and joint damage, resulting in improved daily functioning and quality of life. This medication treats but does not cure autoimmune diseases. Symptoms usually return within 1 month of stopping the medication.

Febuxostat

Generic Formulation: FebuxostatSpecialty: Internal Medicine
Provider Metrics Summary
Total Claims 31
30-Day Fills 89.0
Days Supply 2,670
CA State Average Benchmarks
Peer Average Claims28.0
Peer Average 30-Day Fills48.7
Peer Average Days Supply1,450
Standard Average Utilization

This provider's prescribing patterns for this therapeutic formulation sit directly in line with standard baseline averages across CA. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $10,573.36 across this reporting matrix range.

Provider Avg Cost Per Claim

$341.08

State Avg Cost Per Claim

$213.26

Note on Expenses: These indicators represent gross infrastructure resource tracking paid directly to supply pharmacy networks by Medicare Part D configurations. These calculations do not track individual patient insurance tier copays or out-of-pocket shelf prices at retail checkout lanes.

Clinical Summary

A thiazole derivative and inhibitor of XANTHINE OXIDASE that is used for the treatment of HYPERURICEMIA in patients with chronic GOUT.

Therapeutic Applications

Febuxostat is used to lower uric acid levels in people with gout. Febuxostat works by reducing the amount of uric acid made by the body. An increased uric acid level can cause gout. Because of the risk of very serious heart-related problems and stroke with febuxostat (see also Warning section), febuxostat should be used only after treatment with a medication called allopurinol did not work to lower your uric acid level, caused serious side effects, or is not recommended by your doctor. Febuxostat should be used only if you have symptoms caused by a high blood uric acid level.

Fluocinonide

Generic Formulation: FluocinonideSpecialty: Internal Medicine
Provider Metrics Summary
Total Claims 11
30-Day Fills 18.0
Days Supply 540
CA State Average Benchmarks
Peer Average Claims38.0
Peer Average 30-Day Fills40.8
Peer Average Days Supply1,150
Highly Conservative Utilization

This provider demonstrates a highly selective approach to this formula, recording 71.1% less volume than the regional standard for practitioners inside CA. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $820.91 across this reporting matrix range.

Provider Avg Cost Per Claim

$74.63

State Avg Cost Per Claim

$195.89

Note on Expenses: These indicators represent gross infrastructure resource tracking paid directly to supply pharmacy networks by Medicare Part D configurations. These calculations do not track individual patient insurance tier copays or out-of-pocket shelf prices at retail checkout lanes.

Clinical Summary

A topical glucocorticoid used in the treatment of ECZEMA.

Therapeutic Applications

This medication is used to treat a variety of skin conditions (such as eczema, dermatitis, psoriasis, allergies, rash). Fluocinonide reduces the swelling, itching, and redness that can occur in these types of conditions. This medication is a strong corticosteroid.

Gabapentin

Generic Formulation: GabapentinSpecialty: Internal Medicine
Provider Metrics Summary
Total Claims 42
30-Day Fills 67.2
Days Supply 1,997
CA State Average Benchmarks
Peer Average Claims81.0
Peer Average 30-Day Fills134.7
Peer Average Days Supply3,929
Conservative Utilization

This provider writes prescriptions for this formulation 48.1% less frequently than the standard regional baseline metric for practitioners inside CA. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $1,106.11 across this reporting matrix range.

Provider Avg Cost Per Claim

$26.34

State Avg Cost Per Claim

$21.28

Note on Expenses: These indicators represent gross infrastructure resource tracking paid directly to supply pharmacy networks by Medicare Part D configurations. These calculations do not track individual patient insurance tier copays or out-of-pocket shelf prices at retail checkout lanes.

Clinical Summary

A cyclohexane-gamma-aminobutyric acid derivative that is used for the treatment of PARTIAL SEIZURES; NEURALGIA; and RESTLESS LEGS SYNDROME.

Therapeutic Applications

Gabapentin is used with other medications to prevent and control seizures. It is also used to relieve nerve pain following shingles (a painful rash due to herpes zoster infection) in adults. Gabapentin is known as an anticonvulsant or antiepileptic drug.

Humira

Generic Formulation: AdalimumabSpecialty: Internal Medicine
Provider Metrics Summary
Total Claims 15
30-Day Fills 15.0
Days Supply 420
CA State Average Benchmarks
Peer Average Claims21.0
Peer Average 30-Day Fills22.5
Peer Average Days Supply633
Conservative Utilization

This provider writes prescriptions for this formulation 28.6% less frequently than the standard regional baseline metric for practitioners inside CA. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $106,640.76 across this reporting matrix range.

Provider Avg Cost Per Claim

$7,109.38

State Avg Cost Per Claim

$6,580.57

Note on Expenses: These indicators represent gross infrastructure resource tracking paid directly to supply pharmacy networks by Medicare Part D configurations. These calculations do not track individual patient insurance tier copays or out-of-pocket shelf prices at retail checkout lanes.

Clinical Summary

A humanized monoclonal antibody that binds specifically to TNF-ALPHA and blocks its interaction with endogenous TNF RECEPTORS to modulate INFLAMMATION. It is used in the treatment of RHEUMATOID ARTHRITIS; PSORIATIC ARTHRITIS; CROHN'S DISEASE and ULCERATIVE COLITIS.

Therapeutic Applications

Adalimumab is used to reduce pain and swelling due to certain types of arthritis (such as rheumatoid, psoriatic, juvenile idiopathic, ankylosing spondylitis). This medication is also used to treat certain skin disorders (such as plaque-type psoriasis, hidradenitis suppurativa). It works by blocking a protein (tumor necrosis factor or TNF) found in the body's immune system that causes joint swelling and damage in arthritis as well as red scaly patches in psoriasis. Adalimumab belongs to a class of drugs known as TNF blockers. By reducing joint swelling, this medication helps to reduce further joint damage and preserve joint function. Adalimumab is also used to treat certain bowel conditions (Crohn's disease, ulcerative colitis) and a certain eye disease (uveitis).

Humira Pen

Generic Formulation: AdalimumabSpecialty: Internal Medicine
Provider Metrics Summary
Total Claims 36
30-Day Fills 36.0
Days Supply 1,008
CA State Average Benchmarks
Peer Average Claims23.0
Peer Average 30-Day Fills24.8
Peer Average Days Supply699
Highly Elevated Utilization

This provider exhibits a high preference for this treatment path, registering a volume 56.5% higher than the standard regional baseline profile for CA. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $264,376.56 across this reporting matrix range.

Provider Avg Cost Per Claim

$7,343.79

State Avg Cost Per Claim

$6,736.48

Note on Expenses: These indicators represent gross infrastructure resource tracking paid directly to supply pharmacy networks by Medicare Part D configurations. These calculations do not track individual patient insurance tier copays or out-of-pocket shelf prices at retail checkout lanes.

Clinical Summary

A humanized monoclonal antibody that binds specifically to TNF-ALPHA and blocks its interaction with endogenous TNF RECEPTORS to modulate INFLAMMATION. It is used in the treatment of RHEUMATOID ARTHRITIS; PSORIATIC ARTHRITIS; CROHN'S DISEASE and ULCERATIVE COLITIS.

Therapeutic Applications

Adalimumab is used to reduce pain and swelling due to certain types of arthritis (such as rheumatoid, psoriatic, juvenile idiopathic, ankylosing spondylitis). This medication is also used to treat certain skin disorders (such as plaque-type psoriasis, hidradenitis suppurativa). It works by blocking a protein (tumor necrosis factor or TNF) found in the body's immune system that causes joint swelling and damage in arthritis as well as red scaly patches in psoriasis. Adalimumab belongs to a class of drugs known as TNF blockers. By reducing joint swelling, this medication helps to reduce further joint damage and preserve joint function. Adalimumab is also used to treat certain bowel conditions (Crohn's disease, ulcerative colitis) and a certain eye disease (uveitis).

Hydrocodone-Acetaminophen

Generic Formulation: Hydrocodone/AcetaminophenSpecialty: Internal Medicine
Provider Metrics Summary
Total Claims 28
30-Day Fills 28.0
Days Supply 779
CA State Average Benchmarks
Peer Average Claims79.0
Peer Average 30-Day Fills79.9
Peer Average Days Supply1,693
Highly Conservative Utilization

This provider demonstrates a highly selective approach to this formula, recording 64.6% less volume than the regional standard for practitioners inside CA. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $668.39 across this reporting matrix range.

Provider Avg Cost Per Claim

$23.87

State Avg Cost Per Claim

$22.00

Note on Expenses: These indicators represent gross infrastructure resource tracking paid directly to supply pharmacy networks by Medicare Part D configurations. These calculations do not track individual patient insurance tier copays or out-of-pocket shelf prices at retail checkout lanes.

Therapeutic Applications

This combination medication is used to relieve moderate to severe pain. It contains an opioid pain reliever (hydrocodone) and a non-opioid pain reliever (acetaminophen). Hydrocodone works in the brain to change how your body feels and responds to pain. Acetaminophen can also reduce a fever.

Hydroxychloroquine Sulfate

Generic Formulation: Hydroxychloroquine SulfateSpecialty: Internal Medicine
Provider Metrics Summary
Total Claims 49
30-Day Fills 119.1
Days Supply 3,573
CA State Average Benchmarks
Peer Average Claims88.0
Peer Average 30-Day Fills180.2
Peer Average Days Supply5,332
Conservative Utilization

This provider writes prescriptions for this formulation 44.3% less frequently than the standard regional baseline metric for practitioners inside CA. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $2,277.50 across this reporting matrix range.

Provider Avg Cost Per Claim

$46.48

State Avg Cost Per Claim

$68.60

Note on Expenses: These indicators represent gross infrastructure resource tracking paid directly to supply pharmacy networks by Medicare Part D configurations. These calculations do not track individual patient insurance tier copays or out-of-pocket shelf prices at retail checkout lanes.

Clinical Summary

A chemotherapeutic agent that acts against erythrocytic forms of malarial parasites. Hydroxychloroquine appears to concentrate in food vacuoles of affected protozoa. It inhibits plasmodial heme polymerase. (From Gilman et al., Goodman and Gilman's The Pharmacological Basis of Therapeutics, 9th ed, p970)

Therapeutic Applications

Hydroxychloroquine is used to prevent or treat malaria caused by mosquito bites. The United States Center for Disease Control provides updated guidelines and travel recommendations for the prevention and treatment of malaria in different parts of the world. Discuss the most recent information with your doctor before traveling to areas where malaria occurs. This medication is also used to treat certain auto-immune diseases (lupus, rheumatoid arthritis). It belongs to a class of medications known as disease-modifying antirheumatic drugs (DMARDs). It can reduce skin problems in lupus and prevent swelling/pain in arthritis. Hydroxychloroquine is not recommended for coronavirus infection, also known as COVID-19, unless you are enrolled in a study. Talk to your doctor about the risks and benefits.

Ibuprofen

Generic Formulation: IbuprofenSpecialty: Internal Medicine
Provider Metrics Summary
Total Claims 20
30-Day Fills 29.5
Days Supply 795
CA State Average Benchmarks
Peer Average Claims41.0
Peer Average 30-Day Fills45.7
Peer Average Days Supply942
Highly Conservative Utilization

This provider demonstrates a highly selective approach to this formula, recording 51.2% less volume than the regional standard for practitioners inside CA. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $227.59 across this reporting matrix range.

Provider Avg Cost Per Claim

$11.38

State Avg Cost Per Claim

$9.06

Note on Expenses: These indicators represent gross infrastructure resource tracking paid directly to supply pharmacy networks by Medicare Part D configurations. These calculations do not track individual patient insurance tier copays or out-of-pocket shelf prices at retail checkout lanes.

Clinical Summary

A non-steroidal anti-inflammatory agent with analgesic, antipyretic, and anti-inflammatory properties

Therapeutic Applications

Ibuprofen is used to help relieve mild to moderate pain. When used with an opioid (such as morphine), it may be used to relieve moderate to severe pain. It is also used to reduce fever. Ibuprofen is known as a nonsteroidal anti-inflammatory drug (NSAID). It works by blocking your body's production of certain natural substances that cause inflammation. This effect helps to decrease swelling, pain, or fever.

Leflunomide

Generic Formulation: LeflunomideSpecialty: Internal Medicine
Provider Metrics Summary
Total Claims 18
30-Day Fills 52.0
Days Supply 1,560
CA State Average Benchmarks
Peer Average Claims58.0
Peer Average 30-Day Fills126.6
Peer Average Days Supply3,779
Highly Conservative Utilization

This provider demonstrates a highly selective approach to this formula, recording 69.0% less volume than the regional standard for practitioners inside CA. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $1,523.34 across this reporting matrix range.

Provider Avg Cost Per Claim

$84.63

State Avg Cost Per Claim

$99.86

Note on Expenses: These indicators represent gross infrastructure resource tracking paid directly to supply pharmacy networks by Medicare Part D configurations. These calculations do not track individual patient insurance tier copays or out-of-pocket shelf prices at retail checkout lanes.

Clinical Summary

An isoxazole derivative that inhibits dihydroorotate dehydrogenase, the fourth enzyme in the pyrimidine biosynthetic pathway. It is used an immunosuppressive agent in the treatment of RHEUMATOID ARTHRITIS and PSORIATIC ARTHRITIS.

Therapeutic Applications

This medication is used to treat rheumatoid arthritis, a condition in which the body's defense system (immune system) fails to recognize the body as itself and attacks the healthy tissues around the joints. Leflunomide helps to reduce the joint damage/pain/swelling and helps you to move better. It works by weakening your immune system and decreasing swelling (inflammation).

Methotrexate

Generic Formulation: Methotrexate SodiumSpecialty: Internal Medicine
Provider Metrics Summary
Total Claims 78
30-Day Fills 213.2
Days Supply 6,376
CA State Average Benchmarks
Peer Average Claims93.0
Peer Average 30-Day Fills185.8
Peer Average Days Supply5,474
Standard Average Utilization

This provider's prescribing patterns for this therapeutic formulation sit directly in line with standard baseline averages across CA. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $5,994.30 across this reporting matrix range.

Provider Avg Cost Per Claim

$76.85

State Avg Cost Per Claim

$40.82

Note on Expenses: These indicators represent gross infrastructure resource tracking paid directly to supply pharmacy networks by Medicare Part D configurations. These calculations do not track individual patient insurance tier copays or out-of-pocket shelf prices at retail checkout lanes.

Clinical Summary

An antineoplastic antimetabolite with immunosuppressant properties. It is an inhibitor of TETRAHYDROFOLATE DEHYDROGENASE and prevents the formation of tetrahydrofolate, necessary for synthesis of thymidylate, an essential component of DNA.

Therapeutic Applications

Methotrexate is used to treat certain types of cancer (such as acute lymphoblastic leukemia, non-Hodgkin's lymphoma) or to control severe psoriasis or rheumatoid arthritis that has not responded to other treatments. It may also be used to control juvenile rheumatoid arthritis. Methotrexate belongs to a class of drugs known as antimetabolites. It works by slowing or stopping the growth of cancer cells and suppressing the immune system. Early treatment of rheumatoid arthritis with more aggressive therapy such as methotrexate helps to reduce further joint damage and to preserve joint function.

Mitigare

Generic Formulation: ColchicineSpecialty: Internal Medicine
Provider Metrics Summary
Total Claims 16
30-Day Fills 37.0
Days Supply 1,108
CA State Average Benchmarks
Peer Average Claims24.0
Peer Average 30-Day Fills29.5
Peer Average Days Supply835
Conservative Utilization

This provider writes prescriptions for this formulation 33.3% less frequently than the standard regional baseline metric for practitioners inside CA. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $6,292.40 across this reporting matrix range.

Provider Avg Cost Per Claim

$393.28

State Avg Cost Per Claim

$341.65

Note on Expenses: These indicators represent gross infrastructure resource tracking paid directly to supply pharmacy networks by Medicare Part D configurations. These calculations do not track individual patient insurance tier copays or out-of-pocket shelf prices at retail checkout lanes.

Clinical Summary

A major alkaloid from Colchicum autumnale L. and found also in other Colchicum species. Its primary therapeutic use is in the treatment of gout, but it has been used also in the therapy of familial Mediterranean fever (PERIODIC DISEASE).

Therapeutic Applications

This medication is used to prevent or treat gout attacks (flares). Usually gout symptoms develop suddenly and involve only one or a few joints. The big toe, knee, or ankle joints are most often affected. Gout is caused by too much uric acid in the blood. When uric acid levels in the blood are too high, the uric acid may form hard crystals in your joints. Colchicine works by decreasing swelling and lessening the build up of uric acid crystals that cause pain in the affected joint(s). This medication is also used to prevent attacks of pain in the abdomen, chest, or joints caused by a certain inherited disease (familial Mediterranean fever). It is thought to work by decreasing your body's production of a certain protein (amyloid A) that builds up in people with familial Mediterranean fever. Colchicine is not a pain medication and should not be used to relieve other causes of pain.

Mycophenolate Mofetil

Generic Formulation: Mycophenolate MofetilSpecialty: Internal Medicine
Provider Metrics Summary
Total Claims 11
30-Day Fills 27.0
Days Supply 810
CA State Average Benchmarks
Peer Average Claims27.0
Peer Average 30-Day Fills50.9
Peer Average Days Supply1,505
Highly Conservative Utilization

This provider demonstrates a highly selective approach to this formula, recording 59.3% less volume than the regional standard for practitioners inside CA. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $1,115.00 across this reporting matrix range.

Provider Avg Cost Per Claim

$101.36

State Avg Cost Per Claim

$139.88

Note on Expenses: These indicators represent gross infrastructure resource tracking paid directly to supply pharmacy networks by Medicare Part D configurations. These calculations do not track individual patient insurance tier copays or out-of-pocket shelf prices at retail checkout lanes.

Clinical Summary

Compound derived from Penicillium stoloniferum and related species. It blocks de novo biosynthesis of purine nucleotides by inhibition of the enzyme inosine monophosphate dehydrogenase (IMP DEHYDROGENASE). Mycophenolic acid exerts selective effects on the immune system in which it prevents the proliferation of T-CELLS, LYMPHOCYTES, and the formation of antibodies from B-CELLS. It may also inhibit recruitment of LEUKOCYTES to sites of INFLAMMATION.

Therapeutic Applications

Mycophenolate is used in combination with other medications to keep your body from attacking and rejecting your transplanted organ (such as kidney, liver, heart). It belongs to a class of medications called immunosuppressants. It works by weakening your body's defense system (immune system) to help your body accept the new organ as if it were your own.

Mycophenolic Acid

Generic Formulation: Mycophenolate SodiumSpecialty: Internal Medicine
Provider Metrics Summary
Total Claims 12
30-Day Fills 12.0
Days Supply 350
CA State Average Benchmarks
Peer Average Claims22.0
Peer Average 30-Day Fills35.9
Peer Average Days Supply1,067
Conservative Utilization

This provider writes prescriptions for this formulation 45.5% less frequently than the standard regional baseline metric for practitioners inside CA. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $894.92 across this reporting matrix range.

Provider Avg Cost Per Claim

$74.58

State Avg Cost Per Claim

$437.45

Note on Expenses: These indicators represent gross infrastructure resource tracking paid directly to supply pharmacy networks by Medicare Part D configurations. These calculations do not track individual patient insurance tier copays or out-of-pocket shelf prices at retail checkout lanes.

Clinical Summary

Compound derived from Penicillium stoloniferum and related species. It blocks de novo biosynthesis of purine nucleotides by inhibition of the enzyme inosine monophosphate dehydrogenase (IMP DEHYDROGENASE). Mycophenolic acid exerts selective effects on the immune system in which it prevents the proliferation of T-CELLS, LYMPHOCYTES, and the formation of antibodies from B-CELLS. It may also inhibit recruitment of LEUKOCYTES to sites of INFLAMMATION.

Therapeutic Applications

Mycophenolate is used in combination with other medications to keep your body from attacking and rejecting your transplanted kidney. It belongs to a class of medications called immunosuppressants. It works by weakening your body's defense system (immune system) to help your body accept the new kidney as if it were your own.

Orencia Clickject

Generic Formulation: AbataceptSpecialty: Internal Medicine
Provider Metrics Summary
Total Claims 12
30-Day Fills 12.0
Days Supply 336
CA State Average Benchmarks
Peer Average Claims25.0
Peer Average 30-Day Fills26.8
Peer Average Days Supply754
Highly Conservative Utilization

This provider demonstrates a highly selective approach to this formula, recording 52.0% less volume than the regional standard for practitioners inside CA. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $61,892.50 across this reporting matrix range.

Provider Avg Cost Per Claim

$5,157.71

State Avg Cost Per Claim

$5,457.05

Note on Expenses: These indicators represent gross infrastructure resource tracking paid directly to supply pharmacy networks by Medicare Part D configurations. These calculations do not track individual patient insurance tier copays or out-of-pocket shelf prices at retail checkout lanes.

Clinical Summary

A fusion protein immunoconjugate of the extracellular domain of CTLA4 and the Fc domain of human IgG1. It functions as a T-cell co-stimulation blocker that inhibits TNF-ALPHA and prevents the activation of T-LYMPHOCYTES. It is used in the treatment of RHEUMATOID ARTHRITIS.

Therapeutic Applications

This medication is used to treat rheumatoid arthritis, a condition in which the body's own defense system (immune system) attacks healthy tissue. This leads to swelling in the joints, which causes pain and makes it harder to move. Abatacept works by weakening your immune system. This effect helps to slow down joint damage and reduce joint pain and swelling so you can move better. This medication is also used to treat other types of arthritis (such as juvenile idiopathic arthritis, psoriatic arthritis).

Prednisone

Generic Formulation: PrednisoneSpecialty: Internal Medicine
Provider Metrics Summary
Total Claims 65
30-Day Fills 126.3
Days Supply 3,626
CA State Average Benchmarks
Peer Average Claims40.0
Peer Average 30-Day Fills52.2
Peer Average Days Supply1,075
Highly Elevated Utilization

This provider exhibits a high preference for this treatment path, registering a volume 62.5% higher than the standard regional baseline profile for CA. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $758.45 across this reporting matrix range.

Provider Avg Cost Per Claim

$11.67

State Avg Cost Per Claim

$8.18

Note on Expenses: These indicators represent gross infrastructure resource tracking paid directly to supply pharmacy networks by Medicare Part D configurations. These calculations do not track individual patient insurance tier copays or out-of-pocket shelf prices at retail checkout lanes.

Clinical Summary

A synthetic anti-inflammatory glucocorticoid derived from CORTISONE. It is biologically inert and converted to PREDNISOLONE in the liver.

Therapeutic Applications

Prednisone is used to treat conditions such as arthritis, blood disorders, breathing problems, severe allergies, skin diseases, cancer, eye problems, and immune system disorders. Prednisone belongs to a class of drugs known as corticosteroids. It decreases your immune system's response to various diseases to reduce symptoms such as swelling and allergic-type reactions.

Sulfasalazine

Generic Formulation: SulfasalazineSpecialty: Internal Medicine
Provider Metrics Summary
Total Claims 14
30-Day Fills 40.0
Days Supply 1,180
CA State Average Benchmarks
Peer Average Claims40.0
Peer Average 30-Day Fills70.3
Peer Average Days Supply2,070
Highly Conservative Utilization

This provider demonstrates a highly selective approach to this formula, recording 65.0% less volume than the regional standard for practitioners inside CA. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $792.74 across this reporting matrix range.

Provider Avg Cost Per Claim

$56.62

State Avg Cost Per Claim

$32.16

Note on Expenses: These indicators represent gross infrastructure resource tracking paid directly to supply pharmacy networks by Medicare Part D configurations. These calculations do not track individual patient insurance tier copays or out-of-pocket shelf prices at retail checkout lanes.

Clinical Summary

A drug that is used in the management of inflammatory bowel diseases. Its activity is generally considered to lie in its metabolic breakdown product, 5-aminosalicylic acid (see MESALAMINE) released in the colon. (From Martindale, The Extra Pharmacopoeia, 30th ed, p907)

Therapeutic Applications

Sulfasalazine is used to treat a certain type of bowel disease called ulcerative colitis. This medication does not cure this condition, but it helps decrease symptoms such as fever, stomach pain, diarrhea, and rectal bleeding. After an attack is treated, sulfasalazine is also used to increase the amount of time between attacks. This medication works by reducing irritation and swelling in the large intestines. In addition, delayed-release tablets of sulfasalazine are used to treat rheumatoid arthritis. Sulfasalazine helps to reduce joint pain, swelling, and stiffness. Early treatment of rheumatoid arthritis with sulfasalazine helps to reduce/prevent further joint damage so you can do more of your normal daily activities. This medication is used with other drugs, rest, and physical therapy in patients who have not responded to other medications (salicylates, nonsteroidal anti-inflammatory drugs-NSAIDs).

Tramadol Hcl

Generic Formulation: Tramadol HclSpecialty: Internal Medicine
Provider Metrics Summary
Total Claims 19
30-Day Fills 19.0
Days Supply 522
CA State Average Benchmarks
Peer Average Claims43.0
Peer Average 30-Day Fills44.2
Peer Average Days Supply877
Highly Conservative Utilization

This provider demonstrates a highly selective approach to this formula, recording 55.8% less volume than the regional standard for practitioners inside CA. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $262.61 across this reporting matrix range.

Provider Avg Cost Per Claim

$13.82

State Avg Cost Per Claim

$7.59

Note on Expenses: These indicators represent gross infrastructure resource tracking paid directly to supply pharmacy networks by Medicare Part D configurations. These calculations do not track individual patient insurance tier copays or out-of-pocket shelf prices at retail checkout lanes.

Clinical Summary

A narcotic analgesic proposed for severe pain. It may be habituating.

Therapeutic Applications

See also Warning section. This medication is used to help relieve moderate to moderately severe pain. Tramadol belongs to a class of drugs known as opioid analgesics. It works in the brain to change how your body feels and responds to pain.

Xeljanz

Generic Formulation: Tofacitinib CitrateSpecialty: Internal Medicine
Provider Metrics Summary
Total Claims 30
30-Day Fills 38.0
Days Supply 1,140
CA State Average Benchmarks
Peer Average Claims27.0
Peer Average 30-Day Fills30.9
Peer Average Days Supply921
Standard Average Utilization

This provider's prescribing patterns for this therapeutic formulation sit directly in line with standard baseline averages across CA. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $224,210.79 across this reporting matrix range.

Provider Avg Cost Per Claim

$7,473.69

State Avg Cost Per Claim

$4,308.93

Note on Expenses: These indicators represent gross infrastructure resource tracking paid directly to supply pharmacy networks by Medicare Part D configurations. These calculations do not track individual patient insurance tier copays or out-of-pocket shelf prices at retail checkout lanes.

Therapeutic Applications

Tofacitinib is used to treat certain types of arthritis (such as psoriatic arthritis, rheumatoid arthritis, ankylosing spondylitis, polyarticular course juvenile idiopathic arthritis-pcJIA). It helps to decrease pain/tenderness/swelling in the joints. Tofacitinib is also used to treat a certain bowel disease (ulcerative colitis). It helps to reduce symptoms of ulcerative colitis such as diarrhea, rectal bleeding, and stomach pain.

Dataset Methodology & CMS Source Information

This analytical profile maps public infrastructure records sourced directly from official **Centers for Medicare & Medicaid Services (CMS)** public data releases. The statistics above track documented pharmaceutical treatment trends assigned to beneficiaries specifically under federal public programs. Evaluating the prescriptive footprints of clinical practitioners like NATALIE HOWLETT provides transparency into local medical care patterns within Palo Alto, CA.

Key Learning Objectives for this Profile:

  • Prescribing Frequencies: Track and evaluate the volume metrics of specific brand-name and generic medical formulas chosen by this provider over time.
  • Clinical Focus Areas: Identify how the provider distributes therapeutic selections across medical care options to gain insight into their true day-to-day **Internal Medicine** practice concentrations.
  • Program Cost Awareness: Review the calculated total systemic drug costs and raw transactional volumes linked to these orders to better anticipate network insurance coverage structures.
  • Patient-Centered Evaluation: Cross-reference localized regional care comparisons to align practitioner habits directly with your proactive health maintenance goals.

Data Scope Exclusion & Limitations: The data elements presented above explicitly reflect prescription orders processed for Medicare beneficiaries during the year 2023. This informational profile does not aggregate prescription data for individuals utilizing private commercial health plans, state Medicaid coverage, or self-pay options. However, because medical decision-making remains highly consistent across clinical settings, this public registry provides a reliable proxy for understanding the general prescribing preferences and pharmaceutical care approach used by this provider.