JAMES M SULLIVAN JR. MD
Prescription History 1275697161
Internal Medicine - Rheumatology in Garden City, NY


Quality Rating: 84.47 out of 100 score

NPI Status: Active since December 22, 2006

Contact Information

711 STEWART AVE
GARDEN CITY, NY
ZIP 11530
Phone: (516) 222-8654
Fax: (516) 794-6227

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Prescription History for Informed Healthcare Decisions

Explore the verified Medicare Part D prescription history, volume metrics, and calculated drug costs for JAMES M SULLIVAN JR. MD, an active Rheumatology specialist practicing in Garden City, NY. Our medical registry currently tracks 36 unique pharmaceutical formulations prescribed by this provider, representing an estimated volume of 2,587 documented patient claims. Among these therapy options, the most frequently utilized medication is Prednisone, which accounts for 381 claims alone.


Actemra Actpen

Generic Formulation: TocilizumabSpecialty: Rheumatology
Provider Metrics Summary
Total Claims 21
30-Day Fills 21.0
Days Supply 588
NY State Average Benchmarks
Peer Average Claims20.0
Peer Average 30-Day Fills22.8
Peer Average Days Supply623
Standard Average Utilization

This provider's prescribing patterns for this therapeutic formulation sit directly in line with standard baseline averages across NY. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $88,368.42 across this reporting matrix range.

Provider Avg Cost Per Claim

$4,208.02

State Avg Cost Per Claim

$4,061.03

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: Rheumatology
Provider Metrics Summary
Total Claims 262
30-Day Fills 408.7
Days Supply 11,953
NY State Average Benchmarks
Peer Average Claims49.0
Peer Average 30-Day Fills94.5
Peer Average Days Supply2,781
Highly Elevated Utilization

This provider exhibits a high preference for this treatment path, registering a volume 434.7% higher than the standard regional baseline profile for NY. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $1,540.96 across this reporting matrix range.

Provider Avg Cost Per Claim

$5.88

State Avg Cost Per Claim

$10.51

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: Rheumatology
Provider Metrics Summary
Total Claims 203
30-Day Fills 390.4
Days Supply 11,688
NY State Average Benchmarks
Peer Average Claims44.0
Peer Average 30-Day Fills98.6
Peer Average Days Supply2,923
Highly Elevated Utilization

This provider exhibits a high preference for this treatment path, registering a volume 361.4% higher than the standard regional baseline profile for NY. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $2,364.54 across this reporting matrix range.

Provider Avg Cost Per Claim

$11.65

State Avg Cost Per Claim

$14.64

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.

Benlysta

Generic Formulation: BelimumabSpecialty: Rheumatology
Provider Metrics Summary
Total Claims 19
30-Day Fills 19.0
Days Supply 532
NY State Average Benchmarks
Peer Average Claims25.0
Peer Average 30-Day Fills26.4
Peer Average Days Supply743
Standard Average Utilization

This provider's prescribing patterns for this therapeutic formulation sit directly in line with standard baseline averages across NY. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $98,795.74 across this reporting matrix range.

Provider Avg Cost Per Claim

$5,199.78

State Avg Cost Per Claim

$4,473.52

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.

Celecoxib

Generic Formulation: CelecoxibSpecialty: Rheumatology
Provider Metrics Summary
Total Claims 34
30-Day Fills 36.0
Days Supply 1,050
NY State Average Benchmarks
Peer Average Claims40.0
Peer Average 30-Day Fills56.4
Peer Average Days Supply1,640
Standard Average Utilization

This provider's prescribing patterns for this therapeutic formulation sit directly in line with standard baseline averages across NY. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $782.96 across this reporting matrix range.

Provider Avg Cost Per Claim

$23.03

State Avg Cost Per Claim

$52.12

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 pyrazole derivative and selective CYCLOOXYGENASE 2 INHIBITOR that is used to treat symptoms associated with RHEUMATOID ARTHRITIS; OSTEOARTHRITIS and JUVENILE ARTHRITIS, as well as the management of ACUTE PAIN.

Therapeutic Applications

This medication is a nonsteroidal anti-inflammatory drug (NSAID), specifically a COX-2 inhibitor, which relieves pain and swelling (inflammation). It is used to treat arthritis, acute pain, and menstrual pain and discomfort. The pain and swelling relief provided by this medication helps you perform more of your normal daily activities. 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. See also Warning section. This drug works by blocking the enzyme in your body that makes prostaglandins. Decreasing prostaglandins helps to reduce pain and swelling.

Cevimeline Hcl

Generic Formulation: Cevimeline HclSpecialty: Rheumatology
Provider Metrics Summary
Total Claims 13
30-Day Fills 28.8
Days Supply 840
NY State Average Benchmarks
Peer Average Claims21.0
Peer Average 30-Day Fills34.1
Peer Average Days Supply1,001
Conservative Utilization

This provider writes prescriptions for this formulation 38.1% less frequently than the standard regional baseline metric for practitioners inside NY. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $3,184.96 across this reporting matrix range.

Provider Avg Cost Per Claim

$245.00

State Avg Cost Per Claim

$190.27

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 symptoms of dry mouth due to a certain immune disease (Sjogren's syndrome). Cevimeline belongs to a class of drugs known as cholinergic agonists. It works by stimulating certain nerves to increase the amount of saliva you produce, making it easier and more comfortable to speak and swallow.

Colchicine

Generic Formulation: ColchicineSpecialty: Rheumatology
Provider Metrics Summary
Total Claims 58
30-Day Fills 96.2
Days Supply 2,758
NY State Average Benchmarks
Peer Average Claims24.0
Peer Average 30-Day Fills34.8
Peer Average Days Supply963
Highly Elevated Utilization

This provider exhibits a high preference for this treatment path, registering a volume 141.7% higher than the standard regional baseline profile for NY. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $6,958.82 across this reporting matrix range.

Provider Avg Cost Per Claim

$119.98

State Avg Cost Per Claim

$114.75

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 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.

Duloxetine Hcl

Generic Formulation: Duloxetine HclSpecialty: Rheumatology
Provider Metrics Summary
Total Claims 87
30-Day Fills 177.0
Days Supply 5,310
NY State Average Benchmarks
Peer Average Claims45.0
Peer Average 30-Day Fills74.3
Peer Average Days Supply2,170
Highly Elevated Utilization

This provider exhibits a high preference for this treatment path, registering a volume 93.3% higher than the standard regional baseline profile for NY. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $4,000.24 across this reporting matrix range.

Provider Avg Cost Per Claim

$45.98

State Avg Cost Per Claim

$46.11

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 thiophene derivative and selective NEUROTRANSMITTER UPTAKE INHIBITOR for SEROTONIN and NORADRENALINE (SNRI). It is an ANTIDEPRESSIVE AGENT and ANXIOLYTIC, and is also used for the treatment of pain in patients with DIABETES MELLITUS and FIBROMYALGIA.

Therapeutic Applications

Duloxetine is used to treat depression and anxiety. In addition, duloxetine is used to help relieve nerve pain (peripheral neuropathy) in people with diabetes or ongoing pain due to medical conditions such as arthritis, chronic back pain, or fibromyalgia (a condition that causes widespread pain). Duloxetine may improve your mood, sleep, appetite, and energy level, and decrease nervousness. It can also decrease pain due to certain medical conditions. Duloxetine is known as a serotonin-norepinephrine reuptake inhibitor (SNRI). This medication works by helping to restore the balance of certain natural substances (serotonin and norepinephrine) in the brain.

Enbrel Sureclick

Generic Formulation: EtanerceptSpecialty: Rheumatology
Provider Metrics Summary
Total Claims 82
30-Day Fills 101.8
Days Supply 2,912
NY State Average Benchmarks
Peer Average Claims40.0
Peer Average 30-Day Fills46.9
Peer Average Days Supply1,333
Highly Elevated Utilization

This provider exhibits a high preference for this treatment path, registering a volume 105.0% higher than the standard regional baseline profile for NY. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $738,150.65 across this reporting matrix range.

Provider Avg Cost Per Claim

$9,001.84

State Avg Cost Per Claim

$7,791.64

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.

Evenity (2 Syringes)

Generic Formulation: Romosozumab-AqqgSpecialty: Rheumatology
Provider Metrics Summary
Total Claims 15
30-Day Fills 15.0
Days Supply 450
NY State Average Benchmarks
Peer Average Claims34.0
Peer Average 30-Day Fills35.2
Peer Average Days Supply1,046
Highly Conservative Utilization

This provider demonstrates a highly selective approach to this formula, recording 55.9% less volume than the regional standard for practitioners inside NY. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $33,120.67 across this reporting matrix range.

Provider Avg Cost Per Claim

$2,208.04

State Avg Cost Per Claim

$2,304.18

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.

Therapeutic Applications

Romosozumab-aqqg is used to treat bone loss (osteoporosis) for women after menopause who are at high risk of having broken bones (fractures). It works by increasing bone density and strength. This effect helps to decrease the risk of having a fracture.

Febuxostat

Generic Formulation: FebuxostatSpecialty: Rheumatology
Provider Metrics Summary
Total Claims 13
30-Day Fills 15.0
Days Supply 434
NY State Average Benchmarks
Peer Average Claims24.0
Peer Average 30-Day Fills39.8
Peer Average Days Supply1,185
Conservative Utilization

This provider writes prescriptions for this formulation 45.8% less frequently than the standard regional baseline metric for practitioners inside NY. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $2,493.20 across this reporting matrix range.

Provider Avg Cost Per Claim

$191.78

State Avg Cost Per Claim

$190.00

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.

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.

Folic Acid

Generic Formulation: Folic AcidSpecialty: Rheumatology
Provider Metrics Summary
Total Claims 49
30-Day Fills 113.0
Days Supply 3,390
NY State Average Benchmarks
Peer Average Claims23.0
Peer Average 30-Day Fills47.4
Peer Average Days Supply1,394
Highly Elevated Utilization

This provider exhibits a high preference for this treatment path, registering a volume 113.0% higher than the standard regional baseline profile for NY. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $106.98 across this reporting matrix range.

Provider Avg Cost Per Claim

$2.18

State Avg Cost Per Claim

$5.11

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 member of the vitamin B family that stimulates the hematopoietic system. It is present in the liver and kidney and is found in mushrooms, spinach, yeast, green leaves, and grasses (POACEAE). Folic acid is used in the treatment and prevention of folate deficiencies and megaloblastic anemia.

Therapeutic Applications

Folic acid is the man-made form of folate. Folate is a B-vitamin naturally found in some foods. It is needed to form healthy cells, especially red blood cells. Folic acid supplements may come in different forms (such as L-methylfolate, levomefolate, methyltetrahydrofolate). They are used to treat or prevent low folate levels. Low folate levels can lead to certain types of anemia. Conditions that can cause low folate levels include poor diet, pregnancy, alcoholism, liver disease, certain stomach/intestinal problems, kidney dialysis, among others. Women of childbearing age should receive adequate amounts of folic acid either through their diet or supplements to prevent infant spinal cord birth defects.

Furosemide

Generic Formulation: FurosemideSpecialty: Rheumatology
Provider Metrics Summary
Total Claims 12
30-Day Fills 12.0
Days Supply 360
NY State Average Benchmarks
Peer Average Claims72.0
Peer Average 30-Day Fills131.7
Peer Average Days Supply3,744
Highly Conservative Utilization

This provider demonstrates a highly selective approach to this formula, recording 83.3% less volume than the regional standard for practitioners inside NY. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $18.36 across this reporting matrix range.

Provider Avg Cost Per Claim

$1.53

State Avg Cost Per Claim

$6.06

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 benzoic-sulfonamide-furan. It is a diuretic with fast onset and short duration that is used for EDEMA and chronic RENAL INSUFFICIENCY.

Therapeutic Applications

Furosemide is used to reduce extra fluid in the body (edema) caused by conditions such as heart failure, liver disease, and kidney disease. This can lessen symptoms such as shortness of breath and swelling in your arms, legs, and abdomen. This drug is also used to treat high blood pressure. Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. Furosemide is a water pill (diuretic) that causes you to make more urine. This helps your body get rid of extra water and salt.

Gabapentin

Generic Formulation: GabapentinSpecialty: Rheumatology
Provider Metrics Summary
Total Claims 94
30-Day Fills 130.0
Days Supply 3,724
NY State Average Benchmarks
Peer Average Claims78.0
Peer Average 30-Day Fills113.9
Peer Average Days Supply3,301
Standard Average Utilization

This provider's prescribing patterns for this therapeutic formulation sit directly in line with standard baseline averages across NY. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $1,507.95 across this reporting matrix range.

Provider Avg Cost Per Claim

$16.04

State Avg Cost Per Claim

$17.62

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(Cf) Pen

Generic Formulation: AdalimumabSpecialty: Rheumatology
Provider Metrics Summary
Total Claims 54
30-Day Fills 61.2
Days Supply 1,400
NY State Average Benchmarks
Peer Average Claims35.0
Peer Average 30-Day Fills39.4
Peer Average Days Supply1,114
Highly Elevated Utilization

This provider exhibits a high preference for this treatment path, registering a volume 54.3% higher than the standard regional baseline profile for NY. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $451,891.86 across this reporting matrix range.

Provider Avg Cost Per Claim

$8,368.37

State Avg Cost Per Claim

$8,487.50

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: Rheumatology
Provider Metrics Summary
Total Claims 56
30-Day Fills 56.0
Days Supply 1,408
NY State Average Benchmarks
Peer Average Claims57.0
Peer Average 30-Day Fills57.8
Peer Average Days Supply1,255
Standard Average Utilization

This provider's prescribing patterns for this therapeutic formulation sit directly in line with standard baseline averages across NY. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $1,567.56 across this reporting matrix range.

Provider Avg Cost Per Claim

$27.99

State Avg Cost Per Claim

$24.44

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: Rheumatology
Provider Metrics Summary
Total Claims 216
30-Day Fills 522.0
Days Supply 15,660
NY State Average Benchmarks
Peer Average Claims82.0
Peer Average 30-Day Fills151.2
Peer Average Days Supply4,485
Highly Elevated Utilization

This provider exhibits a high preference for this treatment path, registering a volume 163.4% higher than the standard regional baseline profile for NY. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $9,661.02 across this reporting matrix range.

Provider Avg Cost Per Claim

$44.73

State Avg Cost Per Claim

$66.53

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.

Meloxicam

Generic Formulation: MeloxicamSpecialty: Rheumatology
Provider Metrics Summary
Total Claims 42
30-Day Fills 79.7
Days Supply 2,375
NY State Average Benchmarks
Peer Average Claims48.0
Peer Average 30-Day Fills66.8
Peer Average Days Supply1,938
Standard Average Utilization

This provider's prescribing patterns for this therapeutic formulation sit directly in line with standard baseline averages across NY. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $246.45 across this reporting matrix range.

Provider Avg Cost Per Claim

$5.87

State Avg Cost Per Claim

$5.53

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 benzothiazine and thiazole derivative that acts as a NSAID and cyclooxygenase-2 (COX-2) inhibitor. It is used in the treatment of RHEUMATOID ARTHRITIS; OSTEOARTHRITIS; and ANKYLOSING SPONDYLITIS.

Therapeutic Applications

Meloxicam is used to help relieve moderate to severe pain. Meloxicam 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 or pain.

Methotrexate

Generic Formulation: Methotrexate SodiumSpecialty: Rheumatology
Provider Metrics Summary
Total Claims 336
30-Day Fills 902.3
Days Supply 26,981
NY State Average Benchmarks
Peer Average Claims88.0
Peer Average 30-Day Fills155.4
Peer Average Days Supply4,536
Highly Elevated Utilization

This provider exhibits a high preference for this treatment path, registering a volume 281.8% higher than the standard regional baseline profile for NY. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $11,958.81 across this reporting matrix range.

Provider Avg Cost Per Claim

$35.59

State Avg Cost Per Claim

$38.80

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.

Methylprednisolone

Generic Formulation: MethylprednisoloneSpecialty: Rheumatology
Provider Metrics Summary
Total Claims 25
30-Day Fills 25.0
Days Supply 228
NY State Average Benchmarks
Peer Average Claims32.0
Peer Average 30-Day Fills33.4
Peer Average Days Supply271
Standard Average Utilization

This provider's prescribing patterns for this therapeutic formulation sit directly in line with standard baseline averages across NY. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $255.82 across this reporting matrix range.

Provider Avg Cost Per Claim

$10.23

State Avg Cost Per Claim

$11.18

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 PREDNISOLONE derivative with similar anti-inflammatory action.

Therapeutic Applications

Methylprednisolone is used to treat conditions such as arthritis, blood disorders, severe allergic reactions, certain cancers, eye conditions, skin/kidney/intestinal/lung diseases, and immune system disorders. It decreases your immune system's response to various diseases to reduce symptoms such as swelling, pain, and allergic-type reactions. This medication is a corticosteroid hormone. Methylprednisolone may also be used with other medications in hormone disorders.

Mitigare

Generic Formulation: ColchicineSpecialty: Rheumatology
Provider Metrics Summary
Total Claims 14
30-Day Fills 22.0
Days Supply 645
NY State Average Benchmarks
Peer Average Claims16.0
Peer Average 30-Day Fills20.1
Peer Average Days Supply567
Standard Average Utilization

This provider's prescribing patterns for this therapeutic formulation sit directly in line with standard baseline averages across NY. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $3,902.78 across this reporting matrix range.

Provider Avg Cost Per Claim

$278.77

State Avg Cost Per Claim

$274.46

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 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: Rheumatology
Provider Metrics Summary
Total Claims 17
30-Day Fills 39.0
Days Supply 1,170
NY State Average Benchmarks
Peer Average Claims28.0
Peer Average 30-Day Fills45.2
Peer Average Days Supply1,339
Conservative Utilization

This provider writes prescriptions for this formulation 39.3% less frequently than the standard regional baseline metric for practitioners inside NY. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $5,486.38 across this reporting matrix range.

Provider Avg Cost Per Claim

$322.73

State Avg Cost Per Claim

$148.11

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.

Nucynta

Generic Formulation: Tapentadol HclSpecialty: Rheumatology
Provider Metrics Summary
Total Claims 11
30-Day Fills 11.0
Days Supply 330
NY State Average Benchmarks
Peer Average Claims19.0
Peer Average 30-Day Fills19.5
Peer Average Days Supply522
Conservative Utilization

This provider writes prescriptions for this formulation 42.1% less frequently than the standard regional baseline metric for practitioners inside NY. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $14,115.97 across this reporting matrix range.

Provider Avg Cost Per Claim

$1,283.27

State Avg Cost Per Claim

$1,013.05

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 opioid analgesic, MU OPIOID RECEPTOR agonist, and noradrenaline reuptake inhibitor that is used in the treatment of moderate to severe pain, and of pain associated with DIABETIC NEUROPATHIES.

Therapeutic Applications

Tapentadol is used to help relieve moderate to severe short-term pain (such as pain from an injury or after surgery). It 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.

Omeprazole

Generic Formulation: OmeprazoleSpecialty: Rheumatology
Provider Metrics Summary
Total Claims 11
30-Day Fills 33.0
Days Supply 990
NY State Average Benchmarks
Peer Average Claims96.0
Peer Average 30-Day Fills191.0
Peer Average Days Supply5,662
Highly Conservative Utilization

This provider demonstrates a highly selective approach to this formula, recording 88.5% less volume than the regional standard for practitioners inside NY. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $52.80 across this reporting matrix range.

Provider Avg Cost Per Claim

$4.80

State Avg Cost Per Claim

$12.73

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 4-methoxy-3,5-dimethylpyridyl, 5-methoxybenzimidazole derivative of timoprazole that is used in the therapy of STOMACH ULCERS and ZOLLINGER-ELLISON SYNDROME. The drug inhibits an H(+)-K(+)-EXCHANGING ATPASE which is found in GASTRIC PARIETAL CELLS.

Therapeutic Applications

Omeprazole is used to treat certain stomach and esophagus problems (such as acid reflux, ulcers). It works by decreasing the amount of acid your stomach makes. It relieves symptoms such as heartburn, difficulty swallowing, and cough. This medication helps heal acid damage to the stomach and esophagus, helps prevent ulcers, and may help prevent cancer of the esophagus. Omeprazole belongs to a class of drugs known as proton pump inhibitors (PPIs). If you are self-treating with this medication, over-the-counter omeprazole products are used to treat frequent heartburn (occurring 2 or more days a week). Since it may take 1 to 4 days to have full effect, these products do not relieve heartburn right away. For over-the-counter products, carefully read the package instructions to make sure the product is right for you. Check the ingredients on the label even if you have used the product before. The manufacturer may have changed the ingredients. Also, products with similar brand names may contain different ingredients meant for different purposes. Taking the wrong product could harm you.

Orencia Clickject

Generic Formulation: AbataceptSpecialty: Rheumatology
Provider Metrics Summary
Total Claims 26
30-Day Fills 26.0
Days Supply 728
NY State Average Benchmarks
Peer Average Claims22.0
Peer Average 30-Day Fills24.6
Peer Average Days Supply696
Standard Average Utilization

This provider's prescribing patterns for this therapeutic formulation sit directly in line with standard baseline averages across NY. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $151,610.81 across this reporting matrix range.

Provider Avg Cost Per Claim

$5,831.19

State Avg Cost Per Claim

$5,828.81

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).

Oxycodone-Acetaminophen

Generic Formulation: Oxycodone Hcl/AcetaminophenSpecialty: Rheumatology
Provider Metrics Summary
Total Claims 38
30-Day Fills 38.0
Days Supply 917
NY State Average Benchmarks
Peer Average Claims46.0
Peer Average 30-Day Fills46.2
Peer Average Days Supply998
Standard Average Utilization

This provider's prescribing patterns for this therapeutic formulation sit directly in line with standard baseline averages across NY. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $803.59 across this reporting matrix range.

Provider Avg Cost Per Claim

$21.15

State Avg Cost Per Claim

$23.46

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.

Therapeutic Applications

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

Pantoprazole Sodium

Generic Formulation: Pantoprazole SodiumSpecialty: Rheumatology
Provider Metrics Summary
Total Claims 13
30-Day Fills 15.0
Days Supply 450
NY State Average Benchmarks
Peer Average Claims66.0
Peer Average 30-Day Fills125.2
Peer Average Days Supply3,670
Highly Conservative Utilization

This provider demonstrates a highly selective approach to this formula, recording 80.3% less volume than the regional standard for practitioners inside NY. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $100.04 across this reporting matrix range.

Provider Avg Cost Per Claim

$7.70

State Avg Cost Per Claim

$17.75

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

2-pyridinylmethylsulfinylbenzimidazole proton pump inhibitor that is used in the treatment of GASTROESOPHAGEAL REFLUX and PEPTIC ULCER.

Therapeutic Applications

Pantoprazole is used to treat certain stomach and esophagus problems (such as acid reflux). It works by decreasing the amount of acid your stomach makes. This medication relieves symptoms such as heartburn, difficulty swallowing, and cough. It helps heal acid damage to the stomach and esophagus, helps prevent ulcers, and may help prevent cancer of the esophagus. Pantoprazole belongs to a class of drugs known as proton pump inhibitors (PPIs).

Prednisone

Generic Formulation: PrednisoneSpecialty: Rheumatology
Provider Metrics Summary
Total Claims 381
30-Day Fills 533.8
Days Supply 15,712
NY State Average Benchmarks
Peer Average Claims44.0
Peer Average 30-Day Fills53.3
Peer Average Days Supply1,023
Highly Elevated Utilization

This provider exhibits a high preference for this treatment path, registering a volume 765.9% higher than the standard regional baseline profile for NY. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $3,602.04 across this reporting matrix range.

Provider Avg Cost Per Claim

$9.45

State Avg Cost Per Claim

$6.20

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.

Pregabalin

Generic Formulation: PregabalinSpecialty: Rheumatology
Provider Metrics Summary
Total Claims 114
30-Day Fills 114.0
Days Supply 3,420
NY State Average Benchmarks
Peer Average Claims37.0
Peer Average 30-Day Fills40.1
Peer Average Days Supply1,171
Highly Elevated Utilization

This provider exhibits a high preference for this treatment path, registering a volume 208.1% higher than the standard regional baseline profile for NY. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $4,492.31 across this reporting matrix range.

Provider Avg Cost Per Claim

$39.41

State Avg Cost Per Claim

$48.20

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 (GABA) derivative that functions as a CALCIUM CHANNEL BLOCKER and is used as an ANTICONVULSANT as well as an ANTI-ANXIETY AGENT. It is also used as an ANALGESIC in the treatment of NEUROPATHIC PAIN and FIBROMYALGIA.

Therapeutic Applications

This medication is used to treat pain caused by nerve damage due to diabetes, shingles (herpes zoster) infection, or spinal cord injury. This medication is also used to treat pain in people with fibromyalgia. It is also used with other medications to treat certain types of seizures (focal seizures).

Prolia

Generic Formulation: DenosumabSpecialty: Rheumatology
Provider Metrics Summary
Total Claims 16
30-Day Fills 96.0
Days Supply 2,880
NY State Average Benchmarks
Peer Average Claims33.0
Peer Average 30-Day Fills195.6
Peer Average Days Supply5,866
Highly Conservative Utilization

This provider demonstrates a highly selective approach to this formula, recording 51.5% less volume than the regional standard for practitioners inside NY. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $26,512.48 across this reporting matrix range.

Provider Avg Cost Per Claim

$1,657.03

State Avg Cost Per Claim

$1,534.91

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 and an inhibitor of the RANK LIGAND, which regulates OSTEOCLAST differentiation and bone remodeling. It is used as a BONE DENSITY CONSERVATION AGENT in the treatment of OSTEOPOROSIS.

Therapeutic Applications

Denosumab is used to treat bone loss (osteoporosis) in people who have a high risk of getting fractures. Osteoporosis causes bones to become thinner and break more easily. Your chance of developing osteoporosis increases after menopause (in women), as you age, if someone in your family has osteoporosis, or if you take certain medications (such as prednisone) for long periods. This medication works by slowing bone loss to help maintain strong bones and reduce the risk of broken bones (fractures). Denosumab belongs to a class of drugs called monoclonal antibodies. It prevents certain cells in the body (osteoclasts) from breaking down bone.

Rinvoq

Generic Formulation: UpadacitinibSpecialty: Rheumatology
Provider Metrics Summary
Total Claims 59
30-Day Fills 67.0
Days Supply 2,010
NY State Average Benchmarks
Peer Average Claims30.0
Peer Average 30-Day Fills33.4
Peer Average Days Supply1,001
Highly Elevated Utilization

This provider exhibits a high preference for this treatment path, registering a volume 96.7% higher than the standard regional baseline profile for NY. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $420,663.17 across this reporting matrix range.

Provider Avg Cost Per Claim

$7,129.88

State Avg Cost Per Claim

$6,549.69

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

Upadacitinib is used to treat certain types of arthritis (such as psoriatic arthritis, rheumatoid arthritis, axial spondyloarthritis). It helps decrease pain, tenderness, and swelling in the joints. Upadacitinib is also used to treat a skin condition called atopic dermatitis. It reduces swelling, itching, and redness in the skin. This medication may also be 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.

Risedronate Sodium

Generic Formulation: Risedronate SodiumSpecialty: Rheumatology
Provider Metrics Summary
Total Claims 17
30-Day Fills 26.0
Days Supply 756
NY State Average Benchmarks
Peer Average Claims24.0
Peer Average 30-Day Fills51.9
Peer Average Days Supply1,543
Conservative Utilization

This provider writes prescriptions for this formulation 29.2% less frequently than the standard regional baseline metric for practitioners inside NY. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $1,277.79 across this reporting matrix range.

Provider Avg Cost Per Claim

$75.16

State Avg Cost Per Claim

$119.31

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 pyridine and diphosphonic acid derivative that acts as a CALCIUM CHANNEL BLOCKER and inhibits BONE RESORPTION.

Therapeutic Applications

Risedronate 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 to help maintain strong bones and reduce the risk of broken bones (fractures). Risedronate belongs to a class of medications called bisphosphonates.

Tizanidine Hcl

Generic Formulation: Tizanidine HclSpecialty: Rheumatology
Provider Metrics Summary
Total Claims 19
30-Day Fills 28.0
Days Supply 840
NY State Average Benchmarks
Peer Average Claims38.0
Peer Average 30-Day Fills46.3
Peer Average Days Supply1,243
Conservative Utilization

This provider writes prescriptions for this formulation 50.0% less frequently than the standard regional baseline metric for practitioners inside NY. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $181.92 across this reporting matrix range.

Provider Avg Cost Per Claim

$9.57

State Avg Cost Per Claim

$16.07

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

Tramadol Hcl

Generic Formulation: Tramadol HclSpecialty: Rheumatology
Provider Metrics Summary
Total Claims 103
30-Day Fills 105.0
Days Supply 1,957
NY State Average Benchmarks
Peer Average Claims39.0
Peer Average 30-Day Fills39.7
Peer Average Days Supply796
Highly Elevated Utilization

This provider exhibits a high preference for this treatment path, registering a volume 164.1% higher than the standard regional baseline profile for NY. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $607.92 across this reporting matrix range.

Provider Avg Cost Per Claim

$5.90

State Avg Cost Per Claim

$7.95

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: Rheumatology
Provider Metrics Summary
Total Claims 17
30-Day Fills 23.0
Days Supply 690
NY State Average Benchmarks
Peer Average Claims22.0
Peer Average 30-Day Fills25.6
Peer Average Days Supply758
Standard Average Utilization

This provider's prescribing patterns for this therapeutic formulation sit directly in line with standard baseline averages across NY. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $120,762.91 across this reporting matrix range.

Provider Avg Cost Per Claim

$7,103.70

State Avg Cost Per Claim

$5,775.69

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.

Xeljanz Xr

Generic Formulation: Tofacitinib CitrateSpecialty: Rheumatology
Provider Metrics Summary
Total Claims 40
30-Day Fills 84.0
Days Supply 2,520
NY State Average Benchmarks
Peer Average Claims33.0
Peer Average 30-Day Fills39.3
Peer Average Days Supply1,177
Standard Average Utilization

This provider's prescribing patterns for this therapeutic formulation sit directly in line with standard baseline averages across NY. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $452,707.32 across this reporting matrix range.

Provider Avg Cost Per Claim

$11,317.68

State Avg Cost Per Claim

$6,313.66

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.

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 JAMES M SULLIVAN JR. MD provides transparency into local medical care patterns within Garden City, NY.

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 **Rheumatology** 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.