MRS. LISA MARIE WRIGHT PA
Prescription History 1740580539
Physician Assistant in Limon, CO

NPI Status: Active since October 26, 2010

Contact Information

820 1ST STREET
LIMON, CO
ZIP 80828
Phone: (719) 775-2367
Fax: (719) 775-2365

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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 MRS. LISA MARIE WRIGHT PA, an active Physician Assistant specialist practicing in Limon, CO. Our medical registry currently tracks 15 unique pharmaceutical formulations prescribed by this provider, representing an estimated volume of 472 documented patient claims. Among these therapy options, the most frequently utilized medication is Omeprazole, which accounts for 113 claims alone.


Amitriptyline Hcl

Generic Formulation: Amitriptyline HclSpecialty: Physician Assistant
Provider Metrics Summary
Total Claims 14
30-Day Fills 32.0
Days Supply 960
CO State Average Benchmarks
Peer Average Claims21.0
Peer Average 30-Day Fills41.8
Peer Average Days Supply1,238
Conservative Utilization

This provider writes prescriptions for this formulation 33.3% less frequently than the standard regional baseline metric for practitioners inside CO. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $261.96 across this reporting matrix range.

Provider Avg Cost Per Claim

$18.71

State Avg Cost Per Claim

$24.54

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

Therapeutic Applications

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

Budesonide Dr

Generic Formulation: BudesonideSpecialty: Physician Assistant
Provider Metrics Summary
Total Claims 12
30-Day Fills 18.5
Days Supply 554
CO State Average Benchmarks
Peer Average Claims23.0
Peer Average 30-Day Fills29.7
Peer Average Days Supply874
Conservative Utilization

This provider writes prescriptions for this formulation 47.8% less frequently than the standard regional baseline metric for practitioners inside CO. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $4,508.97 across this reporting matrix range.

Provider Avg Cost Per Claim

$375.75

State Avg Cost Per Claim

$130.40

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 glucocorticoid used in the management of ASTHMA, the treatment of various skin disorders, and allergic RHINITIS.

Therapeutic Applications

Budesonide is used to control and prevent symptoms (wheezing and shortness of breath) caused by asthma. This medication belongs to a class of drugs known as corticosteroids. It works directly in the lungs to make breathing easier by reducing the irritation and swelling of the airways. This medication must be used regularly to be effective. It does not work right away and should not be used to relieve sudden asthma attacks. If an asthma attack occurs, use your quick-relief inhaler as prescribed.

Colestipol Hcl

Generic Formulation: Colestipol HclSpecialty: Physician Assistant
Provider Metrics Summary
Total Claims 31
30-Day Fills 49.0
Days Supply 1,470
CO State Average Benchmarks
Peer Average Claims22.0
Peer Average 30-Day Fills34.1
Peer Average Days Supply991
Elevated Utilization

This provider maintains an active emphasis on this therapeutic option, recording 40.9% more claims than the standard regional baseline profile for CO. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $2,230.98 across this reporting matrix range.

Provider Avg Cost Per Claim

$71.97

State Avg Cost Per Claim

$100.05

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

Highly crosslinked and insoluble basic anion exchange resin used as anticholesteremic. It may also may reduce triglyceride levels.

Therapeutic Applications

Colestipol is used along with a proper diet to lower cholesterol in the blood. Lowering cholesterol helps decrease the risk for strokes and heart attacks. In addition to 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. This medication is known as a bile acid-binding resin. It works by removing bile acid from the body. In people with high cholesterol, this causes the liver to make more bile acid by using cholesterol in the blood. This helps to lower the cholesterol levels.

Dicyclomine Hcl

Generic Formulation: Dicyclomine HclSpecialty: Physician Assistant
Provider Metrics Summary
Total Claims 50
30-Day Fills 52.0
Days Supply 1,121
CO State Average Benchmarks
Peer Average Claims20.0
Peer Average 30-Day Fills28.0
Peer Average Days Supply729
Highly Elevated Utilization

This provider exhibits a high preference for this treatment path, registering a volume 150.0% higher than the standard regional baseline profile for CO. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $1,179.42 across this reporting matrix range.

Provider Avg Cost Per Claim

$23.59

State Avg Cost Per Claim

$25.14

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.

Diphenoxylate-Atropine

Generic Formulation: Diphenoxylate Hcl/AtropineSpecialty: Physician Assistant
Provider Metrics Summary
Total Claims 12
30-Day Fills 12.0
Days Supply 270
CO State Average Benchmarks
Peer Average Claims16.0
Peer Average 30-Day Fills17.1
Peer Average Days Supply338
Standard Average Utilization

This provider's prescribing patterns for this therapeutic formulation sit directly in line with standard baseline averages across CO. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $378.66 across this reporting matrix range.

Provider Avg Cost Per Claim

$31.56

State Avg Cost Per Claim

$40.47

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

Therapeutic Applications

This medication is used to treat diarrhea. It helps to decrease the number and frequency of bowel movements. It works by slowing the movement of the intestines. Diphenoxylate is similar to opioid pain relievers, but it acts mainly to slow the gut. Atropine belongs to a class of drugs known as anticholinergics, which help to dry up body fluids and also slow gut movement. This medication should not be used to treat diarrhea caused by certain types of infection (such as C. difficile-associated diarrhea following antibiotic therapy). Talk to your doctor for more details. This medication is not recommended for use in children younger than 6 years due to an increased risk of serious side effects (such as breathing problems).

Famotidine

Generic Formulation: FamotidineSpecialty: Physician Assistant
Provider Metrics Summary
Total Claims 61
30-Day Fills 135.6
Days Supply 4,067
CO State Average Benchmarks
Peer Average Claims12.0
Peer Average 30-Day Fills12.0
Peer Average Days Supply187
Highly Elevated Utilization

This provider exhibits a high preference for this treatment path, registering a volume 408.3% higher than the standard regional baseline profile for CO. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $1,329.19 across this reporting matrix range.

Provider Avg Cost Per Claim

$21.79

State Avg Cost Per Claim

$23.49

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 competitive histamine H2-receptor antagonist. Its main pharmacodynamic effect is the inhibition of gastric secretion.

Therapeutic Applications

Famotidine is used to treat ulcers of the stomach and intestines and to prevent intestinal ulcers from coming back after they have healed. This medication is also used to treat certain stomach and throat (esophagus) problems (such as erosive esophagitis, gastroesophageal reflux disease-GERD, Zollinger-Ellison syndrome). It works by decreasing the amount of acid your stomach makes. It relieves symptoms such as cough that doesn't go away, stomach pain, heartburn, and difficulty swallowing. Famotidine belongs to a class of drugs known as H2 blockers. This medication is also available without a prescription. It is used to prevent and treat heartburn and other symptoms caused by too much acid in the stomach (acid indigestion). If you are taking this medication for self-treatment, it is important to read the manufacturer's package instructions carefully so you know when to consult your doctor or pharmacist.

Humira(Cf) Pen

Generic Formulation: AdalimumabSpecialty: Physician Assistant
Provider Metrics Summary
Total Claims 15
30-Day Fills 15.0
Days Supply 420
CO State Average Benchmarks
Peer Average Claims28.0
Peer Average 30-Day Fills29.2
Peer Average Days Supply819
Conservative Utilization

This provider writes prescriptions for this formulation 46.4% less frequently than the standard regional baseline metric for practitioners inside CO. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $124,735.59 across this reporting matrix range.

Provider Avg Cost Per Claim

$8,315.71

State Avg Cost Per Claim

$8,195.70

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).

Lubiprostone

Generic Formulation: LubiprostoneSpecialty: Physician Assistant
Provider Metrics Summary
Total Claims 14
30-Day Fills 21.5
Days Supply 645
CO State Average Benchmarks
Peer Average Claims17.0
Peer Average 30-Day Fills20.4
Peer Average Days Supply549
Standard Average Utilization

This provider's prescribing patterns for this therapeutic formulation sit directly in line with standard baseline averages across CO. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $6,500.71 across this reporting matrix range.

Provider Avg Cost Per Claim

$464.34

State Avg Cost Per Claim

$318.66

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

Clinical Summary

Member of a bicyclic fatty acid class of compounds derived from PROSTAGLANDIN E1 involved in chloride channel gating.

Therapeutic Applications

This medication is used to treat certain types of constipation (chronic idiopathic constipation, irritable bowel syndrome with constipation). Chronic idiopathic constipation has an unknown cause and is not due to diet, other diseases, or drugs. Lubiprostone is also used to treat constipation caused by opioid medications in people with ongoing pain due to medical conditions other than cancer. This medication may improve symptoms such as bloating and abdominal discomfort, improve stool texture, lessen the need to strain, and decrease the feeling of not completely relieving oneself. Lubiprostone belongs to a class of drugs known as chloride channel activators. It works by increasing the amount of fluid within your intestines, making the passage of stool easier.

Mesalamine

Generic Formulation: MesalamineSpecialty: Physician Assistant
Provider Metrics Summary
Total Claims 39
30-Day Fills 49.0
Days Supply 1,470
CO State Average Benchmarks
Peer Average Claims21.0
Peer Average 30-Day Fills36.8
Peer Average Days Supply1,085
Highly Elevated Utilization

This provider exhibits a high preference for this treatment path, registering a volume 85.7% higher than the standard regional baseline profile for CO. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $21,064.80 across this reporting matrix range.

Provider Avg Cost Per Claim

$540.12

State Avg Cost Per Claim

$801.40

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 anti-inflammatory agent, structurally related to the SALICYLATES, which is active in INFLAMMATORY BOWEL DISEASE. It is considered to be the active moiety of SULPHASALAZINE. (From Martindale, The Extra Pharmacopoeia, 30th ed)

Therapeutic Applications

This medication is 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. Mesalamine belongs to a class of drugs known as aminosalicylates. It works by decreasing swelling in the colon.

Omeprazole

Generic Formulation: OmeprazoleSpecialty: Physician Assistant
Provider Metrics Summary
Total Claims 113
30-Day Fills 234.5
Days Supply 7,033
CO State Average Benchmarks
Peer Average Claims71.0
Peer Average 30-Day Fills170.6
Peer Average Days Supply5,079
Highly Elevated Utilization

This provider exhibits a high preference for this treatment path, registering a volume 59.2% higher than the standard regional baseline profile for CO. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $2,456.83 across this reporting matrix range.

Provider Avg Cost Per Claim

$21.74

State Avg Cost Per Claim

$17.29

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.

Pantoprazole Sodium

Generic Formulation: Pantoprazole SodiumSpecialty: Physician Assistant
Provider Metrics Summary
Total Claims 58
30-Day Fills 123.6
Days Supply 3,707
CO State Average Benchmarks
Peer Average Claims48.0
Peer Average 30-Day Fills104.7
Peer Average Days Supply3,089
Standard Average Utilization

This provider's prescribing patterns for this therapeutic formulation sit directly in line with standard baseline averages across CO. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $1,065.02 across this reporting matrix range.

Provider Avg Cost Per Claim

$18.36

State Avg Cost Per Claim

$20.99

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

Clinical Summary

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: Physician Assistant
Provider Metrics Summary
Total Claims 11
30-Day Fills 11.4
Days Supply 272
CO State Average Benchmarks
Peer Average Claims35.0
Peer Average 30-Day Fills45.2
Peer Average Days Supply872
Highly Conservative Utilization

This provider demonstrates a highly selective approach to this formula, recording 68.6% less volume than the regional standard for practitioners inside CO. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $107.80 across this reporting matrix range.

Provider Avg Cost Per Claim

$9.80

State Avg Cost Per Claim

$7.54

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.

Skyrizi On-Body

Generic Formulation: Risankizumab-RzaaSpecialty: Physician Assistant
Provider Metrics Summary
Total Claims 13
30-Day Fills 17.4
Days Supply 510
CO State Average Benchmarks
Peer Average Claims--
Peer Average 30-Day Fills--
Peer Average Days Supply--

Provider Avg Cost Per Claim

$20,166.41

State Avg Cost Per Claim

--

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 plaque psoriasis and psoriatic arthritis. It is also used to treat a certain bowel condition called Crohn's disease. Risankizumab belongs to a class of drugs known as monoclonal antibodies. It works by blocking a certain natural protein in your body (interleukin-23) that may cause inflammation and swelling.

Stelara

Generic Formulation: UstekinumabSpecialty: Physician Assistant
Provider Metrics Summary
Total Claims 18
30-Day Fills 19.7
Days Supply 562
CO State Average Benchmarks
Peer Average Claims18.0
Peer Average 30-Day Fills28.2
Peer Average Days Supply831
Standard Average Utilization

This provider's prescribing patterns for this therapeutic formulation sit directly in line with standard baseline averages across CO. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $445,189.31 across this reporting matrix range.

Provider Avg Cost Per Claim

$24,732.74

State Avg Cost Per Claim

$26,241.26

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 humanized monoclonal antibody that binds to IL-12 and IL-23 and is used as a DERMATOLOGIC AGENT in the treatment of patients with plaque PSORIASIS who have not responded to other therapies.

Therapeutic Applications

Ustekinumab is used to treat plaque psoriasis, a certain type of arthritis (psoriatic arthritis), or certain bowel conditions (Crohn's disease, ulcerative colitis). It works by blocking certain natural proteins in your body (interleukin-12 and interleukin-23) that cause inflammation (swelling) in these conditions. Ustekinumab does not cure these diseases, but helps to lessen symptoms of the disease. It can help to decrease the amount of plaques in plaque psoriasis, decrease the number of swollen/painful joints in psoriatic arthritis, and decrease symptoms such as abdominal pain/cramping and diarrhea in Crohn's disease and ulcerative colitis.

Xeljanz

Generic Formulation: Tofacitinib CitrateSpecialty: Physician Assistant
Provider Metrics Summary
Total Claims 11
30-Day Fills 11.0
Days Supply 330
CO State Average Benchmarks
Peer Average Claims27.0
Peer Average 30-Day Fills29.2
Peer Average Days Supply871
Highly Conservative Utilization

This provider demonstrates a highly selective approach to this formula, recording 59.3% less volume than the regional standard for practitioners inside CO. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $100,170.29 across this reporting matrix range.

Provider Avg Cost Per Claim

$9,106.39

State Avg Cost Per Claim

$4,344.09

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 MRS. LISA MARIE WRIGHT PA provides transparency into local medical care patterns within Limon, CO.

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 **Physician Assistant** 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.