DR. NAREG KALAMKARIAN MD
Prescription History 1346569944
Internal Medicine - Clinical Cardiac Electrophysiology in Fresno, CA

NPI Status: Active since May 21, 2010

Contact Information

2335 E KASHIAN LN STE 240
FRESNO, CA
ZIP 93701
Phone: (559) 320-0545
Fax: (559) 320-0550

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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 DR. NAREG KALAMKARIAN MD, an active Clinical Cardiac Electrophysiology specialist practicing in Fresno, CA. Our medical registry currently tracks 22 unique pharmaceutical formulations prescribed by this provider, representing an estimated volume of 774 documented patient claims. Among these therapy options, the most frequently utilized medication is Metoprolol Succinate, which accounts for 107 claims alone.


Amiodarone Hcl

Generic Formulation: Amiodarone HclSpecialty: Clinical Cardiac Electrophysiology
Provider Metrics Summary
Total Claims 67
30-Day Fills 210.3
Days Supply 6,315
CA State Average Benchmarks
Peer Average Claims41.0
Peer Average 30-Day Fills82.6
Peer Average Days Supply2,407
Highly Elevated Utilization

This provider exhibits a high preference for this treatment path, registering a volume 63.4% 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 $2,288.47 across this reporting matrix range.

Provider Avg Cost Per Claim

$34.16

State Avg Cost Per Claim

$36.08

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 certain types of serious (possibly fatal) irregular heartbeat (such as recurrent ventricular fibrillation/tachycardia). It is used to restore normal heart rhythm and maintain a regular, steady heartbeat. Amiodarone is known as an anti-arrhythmic drug. It works by blocking certain electrical signals in the heart that can cause an irregular heartbeat.

Amlodipine Besylate

Generic Formulation: Amlodipine BesylateSpecialty: Clinical Cardiac Electrophysiology
Provider Metrics Summary
Total Claims 33
30-Day Fills 104.9
Days Supply 3,150
CA State Average Benchmarks
Peer Average Claims138.0
Peer Average 30-Day Fills343.8
Peer Average Days Supply10,229
Highly Conservative Utilization

This provider demonstrates a highly selective approach to this formula, recording 76.1% 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 $405.13 across this reporting matrix range.

Provider Avg Cost Per Claim

$12.28

State Avg Cost Per Claim

$9.16

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 long-acting dihydropyridine calcium channel blocker. It is effective in the treatment of ANGINA PECTORIS and HYPERTENSION.

Therapeutic Applications

Amlodipine is used with or without other medications to treat high blood pressure. Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. Amlodipine belongs to a class of drugs known as calcium channel blockers. It works by relaxing blood vessels so blood can flow more easily. Amlodipine is also used to prevent certain types of chest pain (angina). It may help to increase your ability to exercise and decrease the frequency of angina attacks. It should not be used to treat attacks of chest pain when they occur. Use other medications (such as sublingual nitroglycerin) to relieve attacks of chest pain as directed by your doctor.

Atenolol

Generic Formulation: AtenololSpecialty: Clinical Cardiac Electrophysiology
Provider Metrics Summary
Total Claims 15
30-Day Fills 50.0
Days Supply 1,500
CA State Average Benchmarks
Peer Average Claims55.0
Peer Average 30-Day Fills150.4
Peer Average Days Supply4,494
Highly Conservative Utilization

This provider demonstrates a highly selective approach to this formula, recording 72.7% 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 $171.77 across this reporting matrix range.

Provider Avg Cost Per Claim

$11.45

State Avg Cost Per Claim

$11.19

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 cardioselective beta-1 adrenergic blocker possessing properties and potency similar to PROPRANOLOL, but without a negative inotropic effect.

Therapeutic Applications

Atenolol is used with or without other medications to treat high blood pressure (hypertension). Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. This medication is also used to treat chest pain (angina) and to improve survival after a heart attack. Atenolol belongs to a class of drugs known as beta blockers. It works by blocking the action of certain natural chemicals in your body, such as epinephrine, on the heart and blood vessels. This effect lowers the heart rate, blood pressure, and strain on the heart.

Atorvastatin Calcium

Generic Formulation: Atorvastatin CalciumSpecialty: Clinical Cardiac Electrophysiology
Provider Metrics Summary
Total Claims 47
30-Day Fills 156.2
Days Supply 4,690
CA State Average Benchmarks
Peer Average Claims194.0
Peer Average 30-Day Fills503.5
Peer Average Days Supply14,987
Highly Conservative Utilization

This provider demonstrates a highly selective approach to this formula, recording 75.8% 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 $901.61 across this reporting matrix range.

Provider Avg Cost Per Claim

$19.18

State Avg Cost Per Claim

$14.16

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 pyrrole and heptanoic acid derivative, HYDROXYMETHYLGLUTARYL-COA REDUCTASE INHIBITOR (statin), and ANTICHOLESTEREMIC AGENT that is used to reduce serum levels of LDL-CHOLESTEROL; APOLIPOPROTEIN B; and TRIGLYCERIDES. It is used to increase serum levels of HDL-CHOLESTEROL in the treatment of HYPERLIPIDEMIAS, and for the prevention of CARDIOVASCULAR DISEASES in patients with multiple risk factors.

Therapeutic Applications

Atorvastatin is used along with a proper diet to help lower bad cholesterol and fats (such as LDL, triglycerides) and raise good cholesterol (HDL) in the blood. It belongs to a group of drugs known as statins. It works by reducing the amount of cholesterol made by the liver. Lowering bad cholesterol and triglycerides and raising good cholesterol decreases the risk of heart disease and helps prevent strokes and heart attacks. In addition to eating a proper diet (such as a low-cholesterol/low-fat diet), other lifestyle changes that may help this medication work better include exercising, losing weight if overweight, and stopping smoking. Consult your doctor for more details.

Bumetanide

Generic Formulation: BumetanideSpecialty: Clinical Cardiac Electrophysiology
Provider Metrics Summary
Total Claims 18
30-Day Fills 54.2
Days Supply 1,626
CA State Average Benchmarks
Peer Average Claims27.0
Peer Average 30-Day Fills50.4
Peer Average Days Supply1,446
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 $1,020.99 across this reporting matrix range.

Provider Avg Cost Per Claim

$56.72

State Avg Cost Per Claim

$63.11

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 sulfamyl diuretic.

Therapeutic Applications

Bumetanide 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. Bumetanide is a water pill (diuretic) that causes you to make more urine. This helps your body get rid of extra water and salt.

Carvedilol

Generic Formulation: CarvedilolSpecialty: Clinical Cardiac Electrophysiology
Provider Metrics Summary
Total Claims 53
30-Day Fills 167.2
Days Supply 5,019
CA State Average Benchmarks
Peer Average Claims57.0
Peer Average 30-Day Fills129.9
Peer Average Days Supply3,847
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 $658.26 across this reporting matrix range.

Provider Avg Cost Per Claim

$12.42

State Avg Cost Per Claim

$12.81

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 carbazole and propanol derivative that acts as a non-cardioselective beta blocker and vasodilator. It has blocking activity for ALPHA 1 ADRENERGIC RECEPTORS and, at higher doses, may function as a blocker of CALCIUM CHANNELS; it also has antioxidant properties. Carvedilol is used in the treatment of HYPERTENSION; ANGINA PECTORIS; and HEART FAILURE. It can also reduce the risk of death following MYOCARDIAL INFARCTION.

Therapeutic Applications

Carvedilol is used to treat high blood pressure and heart failure. It is also used after a heart attack to improve the chance of survival if your heart is not pumping well. Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. This drug works by blocking the action of certain natural substances in your body, such as epinephrine, on the heart and blood vessels. This effect lowers your heart rate, blood pressure, and strain on your heart. Carvedilol belongs to a class of drugs known as alpha and beta blockers.

Clopidogrel

Generic Formulation: Clopidogrel BisulfateSpecialty: Clinical Cardiac Electrophysiology
Provider Metrics Summary
Total Claims 23
30-Day Fills 75.9
Days Supply 2,280
CA State Average Benchmarks
Peer Average Claims48.0
Peer Average 30-Day Fills111.7
Peer Average Days Supply3,306
Highly Conservative Utilization

This provider demonstrates a highly selective approach to this formula, recording 52.1% 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 $461.98 across this reporting matrix range.

Provider Avg Cost Per Claim

$20.09

State Avg Cost Per Claim

$17.32

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 ticlopidine analog and platelet purinergic P2Y receptor antagonist that inhibits adenosine diphosphate-mediated PLATELET AGGREGATION. It is used to prevent THROMBOEMBOLISM in patients with ARTERIAL OCCLUSIVE DISEASES; MYOCARDIAL INFARCTION; STROKE; or ATRIAL FIBRILLATION.

Therapeutic Applications

Clopidogrel is used to prevent heart attacks and strokes in persons with heart disease (recent heart attack), recent stroke, or blood circulation disease (peripheral vascular disease). It is also used with aspirin to treat new/worsening chest pain (new heart attack, unstable angina) and to keep blood vessels open and prevent blood clots after certain procedures (such as cardiac stent). Clopidogrel works by blocking platelets from sticking together and prevents them from forming harmful clots. It is an antiplatelet drug. It helps keep blood flowing smoothly in your body.

Digoxin

Generic Formulation: DigoxinSpecialty: Clinical Cardiac Electrophysiology
Provider Metrics Summary
Total Claims 19
30-Day Fills 63.3
Days Supply 1,900
CA State Average Benchmarks
Peer Average Claims29.0
Peer Average 30-Day Fills64.4
Peer Average Days Supply1,889
Conservative Utilization

This provider writes prescriptions for this formulation 34.5% 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 $492.82 across this reporting matrix range.

Provider Avg Cost Per Claim

$25.94

State Avg Cost Per Claim

$33.90

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 cardiotonic glycoside obtained mainly from Digitalis lanata; it consists of three sugars and the aglycone DIGOXIGENIN. Digoxin has positive inotropic and negative chronotropic activity. It is used to control ventricular rate in ATRIAL FIBRILLATION and in the management of congestive heart failure with atrial fibrillation. Its use in congestive heart failure and sinus rhythm is less certain. The margin between toxic and therapeutic doses is small. (From Martindale, The Extra Pharmacopoeia, 30th ed, p666)

Therapeutic Applications

Digoxin is used to treat heart failure, usually along with other medications. It is also used to treat certain types of irregular heartbeat (such as chronic atrial fibrillation). Treating heart failure may help maintain your ability to walk and exercise and may improve the strength of your heart. Treating an irregular heartbeat can also improve your ability to exercise. Digoxin belongs to a class of medications called cardiac glycosides. It works by affecting certain minerals (sodium and potassium) inside heart cells. This reduces strain on the heart and helps it maintain a normal, steady, and strong heartbeat.

Flecainide Acetate

Generic Formulation: Flecainide AcetateSpecialty: Clinical Cardiac Electrophysiology
Provider Metrics Summary
Total Claims 56
30-Day Fills 179.3
Days Supply 5,385
CA State Average Benchmarks
Peer Average Claims44.0
Peer Average 30-Day Fills105.3
Peer Average Days Supply3,135
Elevated Utilization

This provider maintains an active emphasis on this therapeutic option, recording 27.3% 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 $2,399.98 across this reporting matrix range.

Provider Avg Cost Per Claim

$42.86

State Avg Cost Per Claim

$65.91

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 potent anti-arrhythmia agent, effective in a wide range of ventricular and atrial ARRHYTHMIAS and TACHYCARDIAS.

Therapeutic Applications

This medication is used to treat certain types of serious (possibly fatal) irregular heartbeat (such as sustained ventricular tachycardia and paroxysmal supraventricular tachycardia). It is used to restore normal heart rhythm and maintain a regular, steady heartbeat. It is also used to prevent certain types of irregular heartbeat from returning (such as atrial fibrillation). Flecainide is known as an anti-arrhythmic drug. It works by blocking certain electrical signals in the heart that can cause an irregular heartbeat. Treating an irregular heartbeat can decrease the risk for blood clots, and this effect can reduce your risk of heart attack or stroke. Older adults should discuss the risks and benefits of this medication with their doctor or pharmacist, as well as other effective and possibly safer treatments.

Furosemide

Generic Formulation: FurosemideSpecialty: Clinical Cardiac Electrophysiology
Provider Metrics Summary
Total Claims 51
30-Day Fills 159.9
Days Supply 4,800
CA State Average Benchmarks
Peer Average Claims65.0
Peer Average 30-Day Fills133.2
Peer Average Days Supply3,865
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 $648.56 across this reporting matrix range.

Provider Avg Cost Per Claim

$12.72

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 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.

Isosorbide Mononitrate Er

Generic Formulation: Isosorbide MononitrateSpecialty: Clinical Cardiac Electrophysiology
Provider Metrics Summary
Total Claims 34
30-Day Fills 112.9
Days Supply 3,390
CA State Average Benchmarks
Peer Average Claims35.0
Peer Average 30-Day Fills79.6
Peer Average Days Supply2,362
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 $515.51 across this reporting matrix range.

Provider Avg Cost Per Claim

$15.16

State Avg Cost Per Claim

$19.12

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.

Therapeutic Applications

Isosorbide mononitrate is used to prevent chest pain (angina) in patients with a certain heart condition (coronary artery disease). This medication belongs to a class of drugs known as nitrates. It works by relaxing and widening blood vessels so blood can flow more easily to the heart. This medication will not relieve chest pain once it occurs. Also, it is not intended to be taken just before physical activities (such as exercise or sexual intercourse) to prevent chest pain. Other medications may be prescribed by your doctor for these conditions. Consult your doctor for more details.

Jardiance

Generic Formulation: EmpagliflozinSpecialty: Clinical Cardiac Electrophysiology
Provider Metrics Summary
Total Claims 23
30-Day Fills 44.0
Days Supply 1,320
CA State Average Benchmarks
Peer Average Claims45.0
Peer Average 30-Day Fills89.0
Peer Average Days Supply2,645
Conservative Utilization

This provider writes prescriptions for this formulation 48.9% 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 $11,651.34 across this reporting matrix range.

Provider Avg Cost Per Claim

$506.58

State Avg Cost Per Claim

$1,009.41

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

Empagliflozin is used with a proper diet and exercise program to control high blood sugar in people with type 2 diabetes. Controlling high blood sugar helps prevent kidney damage, blindness, nerve problems, loss of limbs, and sexual function problems. Empagliflozin is also used in patients with type 2 diabetes and heart disease to lower the risk of death from heart attack or stroke. Empagliflozin works by increasing the removal of sugar by your kidneys. Empagliflozin is also used to treat heart failure. It may help you live longer and lower your risk of going to the hospital for heart failure. Empagliflozin works by increasing the removal of sodium by your kidneys.

Lisinopril

Generic Formulation: LisinoprilSpecialty: Clinical Cardiac Electrophysiology
Provider Metrics Summary
Total Claims 32
30-Day Fills 96.5
Days Supply 2,898
CA State Average Benchmarks
Peer Average Claims100.0
Peer Average 30-Day Fills262.9
Peer Average Days Supply7,834
Highly Conservative Utilization

This provider demonstrates a highly selective approach to this formula, recording 68.0% 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 $453.49 across this reporting matrix range.

Provider Avg Cost Per Claim

$14.17

State Avg Cost Per Claim

$9.65

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

One of the ANGIOTENSIN-CONVERTING ENZYME INHIBITORS (ACE inhibitors), orally active, that has been used in the treatment of hypertension and congestive heart failure.

Therapeutic Applications

Lisinopril is used to treat high blood pressure. Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. It is also used to treat heart failure and to improve survival after a heart attack. Lisinopril belongs to a class of drugs known as ACE inhibitors. It works by relaxing blood vessels so blood can flow more easily.

Losartan Potassium

Generic Formulation: Losartan PotassiumSpecialty: Clinical Cardiac Electrophysiology
Provider Metrics Summary
Total Claims 36
30-Day Fills 114.9
Days Supply 3,450
CA State Average Benchmarks
Peer Average Claims116.0
Peer Average 30-Day Fills302.4
Peer Average Days Supply9,023
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 $416.82 across this reporting matrix range.

Provider Avg Cost Per Claim

$11.58

State Avg Cost Per Claim

$13.35

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 antagonist of ANGIOTENSIN TYPE 1 RECEPTOR with antihypertensive activity due to the reduced pressor effect of ANGIOTENSIN II.

Therapeutic Applications

Losartan is used to treat high blood pressure (hypertension) and to help protect the kidneys from damage due to diabetes. It is also used to lower the risk of strokes in patients with high blood pressure and an enlarged heart. Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. Losartan belongs to a class of drugs called angiotensin receptor blockers (ARBs). It works by relaxing blood vessels so that blood can flow more easily.

Metoprolol Succinate

Generic Formulation: Metoprolol SuccinateSpecialty: Clinical Cardiac Electrophysiology
Provider Metrics Summary
Total Claims 107
30-Day Fills 349.0
Days Supply 10,457
CA State Average Benchmarks
Peer Average Claims82.0
Peer Average 30-Day Fills197.7
Peer Average Days Supply5,890
Elevated Utilization

This provider maintains an active emphasis on this therapeutic option, recording 30.5% 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 $2,027.94 across this reporting matrix range.

Provider Avg Cost Per Claim

$18.95

State Avg Cost Per Claim

$20.10

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 selective adrenergic beta-1 blocking agent that is commonly used to treat ANGINA PECTORIS; HYPERTENSION; and CARDIAC ARRHYTHMIAS.

Therapeutic Applications

This medication is a beta-blocker used to treat chest pain (angina), heart failure, and high blood pressure. Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. This drug works by blocking the action of certain natural chemicals in your body (such as epinephrine) that affect the heart and blood vessels. This lowers heart rate, blood pressure, and strain on the heart.

Metoprolol Tartrate

Generic Formulation: Metoprolol TartrateSpecialty: Clinical Cardiac Electrophysiology
Provider Metrics Summary
Total Claims 48
30-Day Fills 131.9
Days Supply 3,931
CA State Average Benchmarks
Peer Average Claims59.0
Peer Average 30-Day Fills138.2
Peer Average Days Supply4,074
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 $514.45 across this reporting matrix range.

Provider Avg Cost Per Claim

$10.72

State Avg Cost Per Claim

$9.13

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 selective adrenergic beta-1 blocking agent that is commonly used to treat ANGINA PECTORIS; HYPERTENSION; and CARDIAC ARRHYTHMIAS.

Therapeutic Applications

Metoprolol is used with or without other medications to treat high blood pressure (hypertension). Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. This medication is also used to treat chest pain (angina) and to improve survival after a heart attack. Metoprolol belongs to a class of drugs known as beta blockers. It works by blocking the action of certain natural chemicals in your body, such as epinephrine, on the heart and blood vessels. This effect lowers the heart rate, blood pressure, and strain on the heart.

Nitroglycerin

Generic Formulation: NitroglycerinSpecialty: Clinical Cardiac Electrophysiology
Provider Metrics Summary
Total Claims 17
30-Day Fills 26.9
Days Supply 762
CA State Average Benchmarks
Peer Average Claims32.0
Peer Average 30-Day Fills40.2
Peer Average Days Supply1,019
Conservative Utilization

This provider writes prescriptions for this formulation 46.9% 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 $396.67 across this reporting matrix range.

Provider Avg Cost Per Claim

$23.33

State Avg Cost Per Claim

$26.57

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 volatile vasodilator which relieves ANGINA PECTORIS by stimulating GUANYLATE CYCLASE and lowering cytosolic calcium. It is also sometimes used for TOCOLYSIS and explosives.

Therapeutic Applications

Nitroglycerin ointment is used to prevent chest pain (angina) in people with a certain heart condition (coronary artery disease). This medication belongs to a class of drugs known as nitrates. Angina occurs when the heart muscle is not getting enough blood. This drug works by relaxing and widening blood vessels so blood can flow more easily to the heart. This medication will not relieve chest pain once it occurs. It is also not intended to be used just before physical activities (such as exercise, sexual activity) to prevent chest pain. Other medications may be needed in these situations. Consult your doctor for more details.

Pradaxa

Generic Formulation: Dabigatran Etexilate MesylateSpecialty: Clinical Cardiac Electrophysiology
Provider Metrics Summary
Total Claims 30
30-Day Fills 80.3
Days Supply 2,410
CA State Average Benchmarks
Peer Average Claims54.0
Peer Average 30-Day Fills130.8
Peer Average Days Supply3,890
Conservative Utilization

This provider writes prescriptions for this formulation 44.4% 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 $8,577.09 across this reporting matrix range.

Provider Avg Cost Per Claim

$285.90

State Avg Cost Per Claim

$487.31

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 THROMBIN inhibitor which acts by binding and blocking thrombogenic activity and the prevention of thrombus formation. It is used to reduce the risk of stroke and systemic EMBOLISM in patients with nonvalvular atrial fibrillation.

Therapeutic Applications

Dabigatran is used to prevent stroke and harmful blood clots (such as in your legs or lungs) if you have a certain type of irregular heartbeat (atrial fibrillation). Dabigatran is also used to treat blood clots in the veins of your legs (deep vein thrombosis) or lungs (pulmonary embolism) and to reduce the risk of them occurring again. This medication may also be used to prevent these blood clots from forming after hip replacement surgery. Dabigatran is an anticoagulant that works by blocking a certain substance (a clotting protein called thrombin) in your blood. This helps to keep blood flowing smoothly in your body. Dabigatran should not be used to prevent blood clots from forming after artificial heart valve replacement. If you have had heart valve surgery, talk to your doctor about the best medication for you. Do not stop taking any medication, including dabigatran, without talking to your doctor first.

Repatha Sureclick

Generic Formulation: EvolocumabSpecialty: Clinical Cardiac Electrophysiology
Provider Metrics Summary
Total Claims 16
30-Day Fills 16.0
Days Supply 448
CA State Average Benchmarks
Peer Average Claims43.0
Peer Average 30-Day Fills61.1
Peer Average Days Supply1,773
Highly Conservative Utilization

This provider demonstrates a highly selective approach to this formula, recording 62.8% 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 $9,230.56 across this reporting matrix range.

Provider Avg Cost Per Claim

$576.91

State Avg Cost Per Claim

$773.39

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

Evolocumab is used along with a proper diet to help lower bad cholesterol (LDL) in the blood. It may be used with other LDL-lowering treatments (such as statin drugs, ezetimibe, LDL apheresis). Evolocumab is also used by people who have heart disease to help prevent heart attacks and strokes. This medication belongs to a class of drugs known as monoclonal antibodies. It works by improving how well your body gets rid of LDL cholesterol. In addition to eating a proper diet (such as a low-cholesterol/low-fat diet), other lifestyle changes that may help this medication work better include exercising, losing weight if overweight, and stopping smoking. Consult your doctor for more details.

Rosuvastatin Calcium

Generic Formulation: Rosuvastatin CalciumSpecialty: Clinical Cardiac Electrophysiology
Provider Metrics Summary
Total Claims 13
30-Day Fills 42.6
Days Supply 1,280
CA State Average Benchmarks
Peer Average Claims86.0
Peer Average 30-Day Fills222.9
Peer Average Days Supply6,667
Highly Conservative Utilization

This provider demonstrates a highly selective approach to this formula, recording 84.9% 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 $215.81 across this reporting matrix range.

Provider Avg Cost Per Claim

$16.60

State Avg Cost Per Claim

$35.52

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.

Clinical Summary

A HYDROXYMETHYLGLUTARYL-COA-REDUCTASE INHIBITOR, or statin, that reduces the plasma concentrations of LDL-CHOLESTEROL; APOLIPOPROTEIN B, and TRIGLYCERIDES while increasing HDL-CHOLESTEROL levels in patients with HYPERCHOLESTEROLEMIA and those at risk for CARDIOVASCULAR DISEASES.

Therapeutic Applications

Rosuvastatin is used along with a proper diet to help lower bad cholesterol and fats (such as LDL, triglycerides) and raise good cholesterol (HDL) in the blood. It belongs to a group of drugs known as statins. It works by reducing the amount of cholesterol made by the liver. Lowering bad cholesterol and triglycerides and raising good cholesterol decreases the risk of heart disease and helps to prevent strokes and heart attacks. In addition to eating a proper diet (such as a low cholesterol/low-fat diet), other lifestyle changes that may help this medication work better include exercising, losing weight if overweight, and stopping smoking. Talk with your doctor for more details.

Sotalol

Generic Formulation: Sotalol HclSpecialty: Clinical Cardiac Electrophysiology
Provider Metrics Summary
Total Claims 18
30-Day Fills 59.9
Days Supply 1,800
CA State Average Benchmarks
Peer Average Claims37.0
Peer Average 30-Day Fills89.4
Peer Average Days Supply2,667
Highly Conservative Utilization

This provider demonstrates a highly selective approach to this formula, recording 51.4% 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 $428.76 across this reporting matrix range.

Provider Avg Cost Per Claim

$23.82

State Avg Cost Per Claim

$26.95

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.

Therapeutic Applications

This medication is used to treat a serious (possibly life-threatening) type of fast heartbeat called sustained ventricular tachycardia. It is also used to treat certain fast/irregular heartbeats (atrial fibrillation/flutter) in patients with severe symptoms such as weakness and shortness of breath. Sotalol helps to lessen these symptoms. It slows the heart rate and helps the heart to beat more normally and regularly. This medication is both a beta blocker and an anti-arrhythmic.

Spironolactone

Generic Formulation: SpironolactoneSpecialty: Clinical Cardiac Electrophysiology
Provider Metrics Summary
Total Claims 18
30-Day Fills 46.0
Days Supply 1,380
CA State Average Benchmarks
Peer Average Claims34.0
Peer Average 30-Day Fills80.2
Peer Average Days Supply2,378
Conservative Utilization

This provider writes prescriptions for this formulation 47.1% 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 $156.03 across this reporting matrix range.

Provider Avg Cost Per Claim

$8.67

State Avg Cost Per Claim

$13.26

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 potassium sparing diuretic that acts by antagonism of aldosterone in the distal renal tubules. It is used mainly in the treatment of refractory edema in patients with congestive heart failure, nephrotic syndrome, or hepatic cirrhosis. Its effects on the endocrine system are utilized in the treatments of hirsutism and acne but they can lead to adverse effects. (From Martindale, The Extra Pharmacopoeia, 30th ed, p827)

Therapeutic Applications

Spironolactone is used to treat high blood pressure and heart failure. Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. It is also used to treat swelling (edema) caused by certain conditions (such as heart failure, liver disease) by removing excess fluid and improving symptoms such as breathing problems. This medication is also used to treat conditions in which the body is making too much of a natural substance (aldosterone). Spironolactone is known as a water pill (potassium-sparing diuretic).

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 DR. NAREG KALAMKARIAN MD provides transparency into local medical care patterns within Fresno, 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 **Clinical Cardiac Electrophysiology** 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.