DR. ROBERT A ENGEL MD
Prescription History 1760460521
Internal Medicine - Cardiovascular Disease in Juana Diaz, PR

NPI Status: Active since January 03, 2006

Contact Information

43 DEGETAU STREET
JUANA DIAZ, PR
ZIP 00795
Phone: (787) 260-8254
Fax: (787) 260-8254

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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. ROBERT A ENGEL MD, an active Cardiovascular Disease specialist practicing in Juana Diaz, PR. Our medical registry currently tracks 55 unique pharmaceutical formulations prescribed by this provider, representing an estimated volume of 2,803 documented patient claims. Among these therapy options, the most frequently utilized medication is Atorvastatin Calcium, which accounts for 302 claims alone.


Alendronate Sodium

Generic Formulation: Alendronate SodiumSpecialty: Cardiology
Provider Metrics Summary
Total Claims 12
30-Day Fills 32.2
Days Supply 964
PR State Average Benchmarks
Peer Average Claims118.0
Peer Average 30-Day Fills185.4
Peer Average Days Supply5,428
Highly Conservative Utilization

This provider demonstrates a highly selective approach to this formula, recording 89.8% less volume than the regional standard for practitioners inside PR. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $81.91 across this reporting matrix range.

Provider Avg Cost Per Claim

$6.83

State Avg Cost Per Claim

$6.86

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

Clinical Summary

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: Cardiology
Provider Metrics Summary
Total Claims 16
30-Day Fills 34.0
Days Supply 1,020
PR State Average Benchmarks
Peer Average Claims55.0
Peer Average 30-Day Fills90.3
Peer Average Days Supply2,695
Highly Conservative Utilization

This provider demonstrates a highly selective approach to this formula, recording 70.9% less volume than the regional standard for practitioners inside PR. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $198.89 across this reporting matrix range.

Provider Avg Cost Per Claim

$12.43

State Avg Cost Per Claim

$10.37

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.

Alprazolam

Generic Formulation: AlprazolamSpecialty: Cardiology
Provider Metrics Summary
Total Claims 22
30-Day Fills 22.0
Days Supply 572
PR State Average Benchmarks
Peer Average Claims108.0
Peer Average 30-Day Fills109.4
Peer Average Days Supply3,207
Highly Conservative Utilization

This provider demonstrates a highly selective approach to this formula, recording 79.6% less volume than the regional standard for practitioners inside PR. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $75.75 across this reporting matrix range.

Provider Avg Cost Per Claim

$3.44

State Avg Cost Per Claim

$5.75

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 triazolobenzodiazepine compound with antianxiety and sedative-hypnotic actions, that is efficacious in the treatment of PANIC DISORDERS, with or without AGORAPHOBIA, and in generalized ANXIETY DISORDERS. (From AMA Drug Evaluations Annual, 1994, p238)

Therapeutic Applications

Alprazolam is used to treat anxiety and panic disorders. It belongs to a class of medications called benzodiazepines which act on the brain and nerves (central nervous system) to produce a calming effect. It works by enhancing the effects of a certain natural chemical in the body (GABA).

Amiodarone Hcl

Generic Formulation: Amiodarone HclSpecialty: Cardiology
Provider Metrics Summary
Total Claims 12
30-Day Fills 36.0
Days Supply 1,080
PR State Average Benchmarks
Peer Average Claims27.0
Peer Average 30-Day Fills42.3
Peer Average Days Supply1,258
Highly Conservative Utilization

This provider demonstrates a highly selective approach to this formula, recording 55.6% less volume than the regional standard for practitioners inside PR. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $274.88 across this reporting matrix range.

Provider Avg Cost Per Claim

$22.91

State Avg Cost Per Claim

$36.90

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.

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: Cardiology
Provider Metrics Summary
Total Claims 158
30-Day Fills 462.0
Days Supply 13,860
PR State Average Benchmarks
Peer Average Claims205.0
Peer Average 30-Day Fills397.3
Peer Average Days Supply11,895
Standard Average Utilization

This provider's prescribing patterns for this therapeutic formulation sit directly in line with standard baseline averages across PR. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $667.90 across this reporting matrix range.

Provider Avg Cost Per Claim

$4.23

State Avg Cost Per Claim

$5.02

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.

Amlodipine Besylate-Benazepril

Generic Formulation: Amlodipine Besylate/BenazeprilSpecialty: Cardiology
Provider Metrics Summary
Total Claims 61
30-Day Fills 163.0
Days Supply 4,890
PR State Average Benchmarks
Peer Average Claims38.0
Peer Average 30-Day Fills79.2
Peer Average Days Supply2,372
Highly Elevated Utilization

This provider exhibits a high preference for this treatment path, registering a volume 60.5% higher than the standard regional baseline profile for PR. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $1,569.26 across this reporting matrix range.

Provider Avg Cost Per Claim

$25.73

State Avg Cost Per Claim

$21.88

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

Therapeutic Applications

This product is a combination of two drugs: a calcium channel blocker (amlodipine) and an ACE inhibitor (benazepril). It is used to treat high blood pressure. It works by relaxing blood vessels so that blood can flow more easily. Lowering high blood pressure helps prevent strokes, heart attacks and kidney problems.

Atenolol

Generic Formulation: AtenololSpecialty: Cardiology
Provider Metrics Summary
Total Claims 22
30-Day Fills 62.0
Days Supply 1,860
PR State Average Benchmarks
Peer Average Claims50.0
Peer Average 30-Day Fills95.5
Peer Average Days Supply2,860
Highly Conservative Utilization

This provider demonstrates a highly selective approach to this formula, recording 56.0% less volume than the regional standard for practitioners inside PR. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $202.40 across this reporting matrix range.

Provider Avg Cost Per Claim

$9.20

State Avg Cost Per Claim

$8.61

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

Clinical Summary

A 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: Cardiology
Provider Metrics Summary
Total Claims 302
30-Day Fills 884.0
Days Supply 26,520
PR State Average Benchmarks
Peer Average Claims321.0
Peer Average 30-Day Fills651.4
Peer Average Days Supply19,501
Standard Average Utilization

This provider's prescribing patterns for this therapeutic formulation sit directly in line with standard baseline averages across PR. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $3,839.74 across this reporting matrix range.

Provider Avg Cost Per Claim

$12.71

State Avg Cost Per Claim

$11.89

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

Clinical Summary

A 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.

Brilinta

Generic Formulation: TicagrelorSpecialty: Cardiology
Provider Metrics Summary
Total Claims 36
30-Day Fills 64.0
Days Supply 1,887
PR State Average Benchmarks
Peer Average Claims30.0
Peer Average 30-Day Fills39.8
Peer Average Days Supply1,188
Standard Average Utilization

This provider's prescribing patterns for this therapeutic formulation sit directly in line with standard baseline averages across PR. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $27,784.58 across this reporting matrix range.

Provider Avg Cost Per Claim

$771.79

State Avg Cost Per Claim

$557.46

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

An adenosine triphosphate analogue and reversible P2Y12 PURINORECEPTOR antagonist that inhibits ADP-mediated PLATELET AGGREGATION. It is used for the prevention of THROMBOEMBOLISM by patients with ACUTE CORONARY SYNDROME or a history of MYOCARDIAL INFARCTION.

Therapeutic Applications

Ticagrelor is used along with low-dose aspirin to help prevent heart attack and stroke in people with a history of heart disease, stroke, or at increased risk for heart disease or stroke (for example, due to diabetes, history of transient ischemic attack-TIA). It may also prevent blood clots after certain heart surgeries (such as stent placement). Ticagrelor works by blocking platelets from sticking together and prevents them from forming harmful clots. It is an antiplatelet drug. It keeps blood flowing smoothly in your body.

Buspirone Hcl

Generic Formulation: Buspirone HclSpecialty: Cardiology
Provider Metrics Summary
Total Claims 14
30-Day Fills 20.0
Days Supply 600
PR State Average Benchmarks
Peer Average Claims94.0
Peer Average 30-Day Fills102.1
Peer Average Days Supply2,992
Highly Conservative Utilization

This provider demonstrates a highly selective approach to this formula, recording 85.1% less volume than the regional standard for practitioners inside PR. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $49.13 across this reporting matrix range.

Provider Avg Cost Per Claim

$3.51

State Avg Cost Per Claim

$7.50

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.

Therapeutic Applications

This medication is used to treat anxiety. It may help you think more clearly, relax, worry less, and take part in everyday life. It may also help you to feel less jittery and irritable, and may control symptoms such as trouble sleeping, sweating, and pounding heartbeat. Buspirone is a medication for anxiety (anxiolytic) that works by affecting certain natural substances in the brain (neurotransmitters).

Carvedilol

Generic Formulation: CarvedilolSpecialty: Cardiology
Provider Metrics Summary
Total Claims 86
30-Day Fills 235.0
Days Supply 7,050
PR State Average Benchmarks
Peer Average Claims86.0
Peer Average 30-Day Fills151.7
Peer Average Days Supply4,528
Standard Average Utilization

This provider's prescribing patterns for this therapeutic formulation sit directly in line with standard baseline averages across PR. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $786.35 across this reporting matrix range.

Provider Avg Cost Per Claim

$9.14

State Avg Cost Per Claim

$7.18

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 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.

Chlorthalidone

Generic Formulation: ChlorthalidoneSpecialty: Cardiology
Provider Metrics Summary
Total Claims 76
30-Day Fills 214.0
Days Supply 6,420
PR State Average Benchmarks
Peer Average Claims42.0
Peer Average 30-Day Fills71.0
Peer Average Days Supply2,126
Highly Elevated Utilization

This provider exhibits a high preference for this treatment path, registering a volume 81.0% higher than the standard regional baseline profile for PR. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $3,308.63 across this reporting matrix range.

Provider Avg Cost Per Claim

$43.53

State Avg Cost Per Claim

$33.78

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 benzenesulfonamide-phthalimidine that tautomerizes to a BENZOPHENONES form. It is considered a thiazide-like diuretic.

Therapeutic Applications

Chlorthalidone is used to treat high blood pressure (hypertension). Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. It is also used to reduce extra salt and water in the body caused by conditions such as heart failure, liver disease, and kidney disease. Decreasing extra salt and water in the body helps to decrease swelling (edema) and breathing problems caused by fluid in the lungs. Chlorthalidone is a water pill (diuretic). It increases the amount of urine you make, especially when you first start the medication. It also helps to relax the blood vessels so that blood can flow more easily.

Cilostazol

Generic Formulation: CilostazolSpecialty: Cardiology
Provider Metrics Summary
Total Claims 15
30-Day Fills 45.0
Days Supply 1,350
PR State Average Benchmarks
Peer Average Claims56.0
Peer Average 30-Day Fills89.1
Peer Average Days Supply2,659
Highly Conservative Utilization

This provider demonstrates a highly selective approach to this formula, recording 73.2% less volume than the regional standard for practitioners inside PR. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $391.61 across this reporting matrix range.

Provider Avg Cost Per Claim

$26.11

State Avg Cost Per Claim

$17.95

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 quinoline and tetrazole derivative that acts as a phosphodiesterase type 3 inhibitor, with anti-platelet and vasodilating activity. It is used in the treatment of PERIPHERAL VASCULAR DISEASES; ISCHEMIC HEART DISEASE; and in the prevention of stroke.

Therapeutic Applications

Cilostazol is used to improve the symptoms of a certain blood flow problem in the legs (intermittent claudication). Cilostazol can decrease the muscle pain/cramps that occur during exercise/walking. Claudication pain is caused by too little oxygen getting to the muscles. Cilostazol can increase blood flow and the amount of oxygen that gets to the muscles. Cilostazol is an antiplatelet drug and a vasodilator. It works by stopping blood cells called platelets from sticking together and prevents them from forming harmful clots. It also widens blood vessels in the legs. Cilostazol helps the blood to move more easily and keeps blood flowing smoothly in your body.

Clonidine Hcl

Generic Formulation: Clonidine HclSpecialty: Cardiology
Provider Metrics Summary
Total Claims 14
30-Day Fills 38.0
Days Supply 1,140
PR State Average Benchmarks
Peer Average Claims34.0
Peer Average 30-Day Fills57.5
Peer Average Days Supply1,710
Highly Conservative Utilization

This provider demonstrates a highly selective approach to this formula, recording 58.8% less volume than the regional standard for practitioners inside PR. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $431.52 across this reporting matrix range.

Provider Avg Cost Per Claim

$30.82

State Avg Cost Per Claim

$7.66

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

This medication is used alone or with other medications to treat high blood pressure (hypertension). Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. Clonidine belongs to a class of drugs (central alpha agonists) that act in the brain to lower blood pressure. It works by relaxing blood vessels so blood can flow more easily.

Clopidogrel

Generic Formulation: Clopidogrel BisulfateSpecialty: Cardiology
Provider Metrics Summary
Total Claims 63
30-Day Fills 189.0
Days Supply 5,670
PR State Average Benchmarks
Peer Average Claims108.0
Peer Average 30-Day Fills189.3
Peer Average Days Supply5,662
Conservative Utilization

This provider writes prescriptions for this formulation 41.7% less frequently than the standard regional baseline metric for practitioners inside PR. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $632.31 across this reporting matrix range.

Provider Avg Cost Per Claim

$10.04

State Avg Cost Per Claim

$10.08

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.

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.

Clotrimazole-Betamethasone

Generic Formulation: Clotrimazole/Betamethasone DipSpecialty: Cardiology
Provider Metrics Summary
Total Claims 11
30-Day Fills 11.0
Days Supply 199
PR State Average Benchmarks
Peer Average Claims63.0
Peer Average 30-Day Fills64.5
Peer Average Days Supply1,334
Highly Conservative Utilization

This provider demonstrates a highly selective approach to this formula, recording 82.5% less volume than the regional standard for practitioners inside PR. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $222.67 across this reporting matrix range.

Provider Avg Cost Per Claim

$20.24

State Avg Cost Per Claim

$24.59

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.

Therapeutic Applications

This combination medication is used to treat a variety of inflamed fungal skin infections such as ringworm, athlete's foot, and jock itch. This product contains 2 medications. Clotrimazole is an azole antifungal that works by preventing the growth of fungus. Betamethasone is a strong corticosteroid that works by reducing the swelling, redness, and itching that occurs in the skin infection. This medication is not recommended for children younger than 17 years or for diaper rash.

Cozaar

Generic Formulation: Losartan PotassiumSpecialty: Cardiology
Provider Metrics Summary
Total Claims 16
30-Day Fills 24.0
Days Supply 720
PR State Average Benchmarks
Peer Average Claims14.0
Peer Average 30-Day Fills14.8
Peer Average Days Supply443
Standard Average Utilization

This provider's prescribing patterns for this therapeutic formulation sit directly in line with standard baseline averages across PR. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $2,306.62 across this reporting matrix range.

Provider Avg Cost Per Claim

$144.16

State Avg Cost Per Claim

$165.34

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.

Eliquis

Generic Formulation: ApixabanSpecialty: Cardiology
Provider Metrics Summary
Total Claims 58
30-Day Fills 147.0
Days Supply 4,410
PR State Average Benchmarks
Peer Average Claims56.0
Peer Average 30-Day Fills74.5
Peer Average Days Supply2,207
Standard Average Utilization

This provider's prescribing patterns for this therapeutic formulation sit directly in line with standard baseline averages across PR. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $81,448.22 across this reporting matrix range.

Provider Avg Cost Per Claim

$1,404.28

State Avg Cost Per Claim

$691.22

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

Apixaban is used to prevent serious blood clots from forming due to a certain irregular heartbeat (atrial fibrillation) or after hip/knee replacement surgery. With atrial fibrillation, part of the heart does not beat the way it should. This can lead to blood clots forming, which can travel to other parts of your body (such as the lungs or legs) or increase your risk for stroke. In the United States, apixaban is also approved to treat certain types of blood clots (deep vein thrombosis-DVT, pulmonary embolus-PE) and to prevent them from forming again. Apixaban is an anticoagulant that works by blocking certain clotting proteins in your blood.

Enalapril Maleate

Generic Formulation: Enalapril MaleateSpecialty: Cardiology
Provider Metrics Summary
Total Claims 40
30-Day Fills 120.0
Days Supply 3,600
PR State Average Benchmarks
Peer Average Claims73.0
Peer Average 30-Day Fills142.9
Peer Average Days Supply4,277
Conservative Utilization

This provider writes prescriptions for this formulation 45.2% less frequently than the standard regional baseline metric for practitioners inside PR. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $1,530.54 across this reporting matrix range.

Provider Avg Cost Per Claim

$38.26

State Avg Cost Per Claim

$26.02

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 angiotensin-converting enzyme inhibitor that is used to treat HYPERTENSION and HEART FAILURE.

Therapeutic Applications

Enalapril 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 help prevent people with a certain heart problem (left ventricular dysfunction) from developing heart failure. Enalapril belongs to a class of drugs known as ACE inhibitors. It works by relaxing blood vessels so blood can flow more easily.

Ezetimibe

Generic Formulation: EzetimibeSpecialty: Cardiology
Provider Metrics Summary
Total Claims 30
30-Day Fills 90.0
Days Supply 2,700
PR State Average Benchmarks
Peer Average Claims72.0
Peer Average 30-Day Fills136.7
Peer Average Days Supply4,098
Highly Conservative Utilization

This provider demonstrates a highly selective approach to this formula, recording 58.3% less volume than the regional standard for practitioners inside PR. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $603.17 across this reporting matrix range.

Provider Avg Cost Per Claim

$20.11

State Avg Cost Per Claim

$19.43

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 azetidine derivative and ANTICHOLESTEREMIC AGENT that inhibits intestinal STEROL absorption. It is used to reduce total CHOLESTEROL; LDL CHOLESTEROL, and APOLIPOPROTEINS B in the treatment of HYPERLIPIDEMIAS.

Therapeutic Applications

Ezetimibe is used along with a low cholesterol/low fat diet and exercise to help lower cholesterol in the blood. Ezetimibe may be used alone or with other drugs (such as statins or fibrates). Ezetimibe works by reducing the amount of cholesterol your body absorbs from your diet. Reducing cholesterol may help prevent strokes and heart attacks.

Famotidine

Generic Formulation: FamotidineSpecialty: Cardiology
Provider Metrics Summary
Total Claims 46
30-Day Fills 62.0
Days Supply 1,860
PR State Average Benchmarks
Peer Average Claims17.0
Peer Average 30-Day Fills17.0
Peer Average Days Supply377
Highly Elevated Utilization

This provider exhibits a high preference for this treatment path, registering a volume 170.6% higher than the standard regional baseline profile for PR. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $510.53 across this reporting matrix range.

Provider Avg Cost Per Claim

$11.10

State Avg Cost Per Claim

$4.18

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 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.

Fenofibrate

Generic Formulation: FenofibrateSpecialty: Cardiology
Provider Metrics Summary
Total Claims 29
30-Day Fills 87.0
Days Supply 2,610
PR State Average Benchmarks
Peer Average Claims42.0
Peer Average 30-Day Fills76.6
Peer Average Days Supply2,293
Conservative Utilization

This provider writes prescriptions for this formulation 31.0% less frequently than the standard regional baseline metric for practitioners inside PR. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $1,089.01 across this reporting matrix range.

Provider Avg Cost Per Claim

$37.55

State Avg Cost Per Claim

$28.37

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 antilipemic agent which reduces both CHOLESTEROL and TRIGLYCERIDES in the blood.

Therapeutic Applications

Fenofibrate 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 works by increasing the natural substance (enzyme) that breaks down fats in the blood. Fenofibrate belongs to a group of drugs known as fibrates. Lowering triglycerides in people with very high triglyceride blood levels may decrease the risk of pancreas disease (pancreatitis). However, fenofibrate might not lower your risk of a heart attack or stroke. Talk to your doctor about the risks and benefits of fenofibrate. 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.

Fenofibric Acid

Generic Formulation: Fenofibric Acid (Choline)Specialty: Cardiology
Provider Metrics Summary
Total Claims 44
30-Day Fills 124.0
Days Supply 3,720
PR State Average Benchmarks
Peer Average Claims35.0
Peer Average 30-Day Fills64.0
Peer Average Days Supply1,916
Elevated Utilization

This provider maintains an active emphasis on this therapeutic option, recording 25.7% more claims than the standard regional baseline profile for PR. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $2,850.68 across this reporting matrix range.

Provider Avg Cost Per Claim

$64.79

State Avg Cost Per Claim

$66.56

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

Fenofibric acid 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 works by increasing the natural substance (enzyme) that breaks down fats in the blood. Fenofibric acid belongs to a group of drugs known as fibrates. Lowering triglycerides in people with very high triglyceride blood levels may decrease the risk of pancreas disease (pancreatitis). However, fenofibric acid might not lower your risk of a heart attack or stroke. Talk to your doctor about the risks and benefits of fenofibric acid. 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.

Furosemide

Generic Formulation: FurosemideSpecialty: Cardiology
Provider Metrics Summary
Total Claims 61
30-Day Fills 161.0
Days Supply 4,830
PR State Average Benchmarks
Peer Average Claims88.0
Peer Average 30-Day Fills142.5
Peer Average Days Supply4,219
Conservative Utilization

This provider writes prescriptions for this formulation 30.7% less frequently than the standard regional baseline metric for practitioners inside PR. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $351.21 across this reporting matrix range.

Provider Avg Cost Per Claim

$5.76

State Avg Cost Per Claim

$5.32

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 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: Cardiology
Provider Metrics Summary
Total Claims 11
30-Day Fills 27.0
Days Supply 810
PR State Average Benchmarks
Peer Average Claims262.0
Peer Average 30-Day Fills390.8
Peer Average Days Supply11,611
Highly Conservative Utilization

This provider demonstrates a highly selective approach to this formula, recording 95.8% less volume than the regional standard for practitioners inside PR. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $229.35 across this reporting matrix range.

Provider Avg Cost Per Claim

$20.85

State Avg Cost Per Claim

$9.48

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

Clinical Summary

A 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.

Hydralazine Hcl

Generic Formulation: Hydralazine HclSpecialty: Cardiology
Provider Metrics Summary
Total Claims 23
30-Day Fills 69.0
Days Supply 2,070
PR State Average Benchmarks
Peer Average Claims55.0
Peer Average 30-Day Fills93.0
Peer Average Days Supply2,770
Highly Conservative Utilization

This provider demonstrates a highly selective approach to this formula, recording 58.2% less volume than the regional standard for practitioners inside PR. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $296.41 across this reporting matrix range.

Provider Avg Cost Per Claim

$12.89

State Avg Cost Per Claim

$11.92

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

Hydralazine is used with or without other medications to treat high blood pressure. Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. Hydralazine is called a vasodilator. It works by relaxing blood vessels so blood can flow through the body more easily.

Hydrochlorothiazide

Generic Formulation: HydrochlorothiazideSpecialty: Cardiology
Provider Metrics Summary
Total Claims 139
30-Day Fills 395.0
Days Supply 11,850
PR State Average Benchmarks
Peer Average Claims125.0
Peer Average 30-Day Fills231.7
Peer Average Days Supply6,930
Standard Average Utilization

This provider's prescribing patterns for this therapeutic formulation sit directly in line with standard baseline averages across PR. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $621.19 across this reporting matrix range.

Provider Avg Cost Per Claim

$4.47

State Avg Cost Per Claim

$4.94

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 thiazide diuretic often considered the prototypical member of this class. It reduces the reabsorption of electrolytes from the renal tubules. This results in increased excretion of water and electrolytes, including sodium, potassium, chloride, and magnesium. It is used in the treatment of several disorders including edema, hypertension, diabetes insipidus, and hypoparathyroidism.

Therapeutic Applications

This medication is used to treat high blood pressure. Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. Hydrochlorothiazide belongs to a class of drugs known as diuretics/water pills. It works by causing you to make more urine. This helps your body get rid of extra salt and water. This medication also reduces extra fluid in the body (edema) caused by conditions such as heart failure, liver disease, or kidney disease. This can lessen symptoms such as shortness of breath or swelling in your ankles or feet.

Indapamide

Generic Formulation: IndapamideSpecialty: Cardiology
Provider Metrics Summary
Total Claims 11
30-Day Fills 33.0
Days Supply 990
PR State Average Benchmarks
Peer Average Claims34.0
Peer Average 30-Day Fills58.3
Peer Average Days Supply1,741
Highly Conservative Utilization

This provider demonstrates a highly selective approach to this formula, recording 67.6% less volume than the regional standard for practitioners inside PR. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $229.76 across this reporting matrix range.

Provider Avg Cost Per Claim

$20.89

State Avg Cost Per Claim

$14.75

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 benzamide-sulfonamide-indole derived DIURETIC that functions by inhibiting SODIUM CHLORIDE SYMPORTERS.

Therapeutic Applications

This medication is used to treat high blood pressure. Indapamide is also used to reduce extra fluid in the body (edema) caused by heart failure. Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. Indapamide belongs to a class of drugs known as diuretics/water pills. It works by causing you to make more urine. This helps your body get rid of extra salt and water. This can lessen symptoms such as shortness of breath or swelling in your ankles or feet.

Irbesartan

Generic Formulation: IrbesartanSpecialty: Cardiology
Provider Metrics Summary
Total Claims 50
30-Day Fills 140.0
Days Supply 4,200
PR State Average Benchmarks
Peer Average Claims75.0
Peer Average 30-Day Fills146.7
Peer Average Days Supply4,393
Conservative Utilization

This provider writes prescriptions for this formulation 33.3% less frequently than the standard regional baseline metric for practitioners inside PR. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $1,636.73 across this reporting matrix range.

Provider Avg Cost Per Claim

$32.73

State Avg Cost Per Claim

$30.07

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.

Clinical Summary

A spiro compound, biphenyl and tetrazole derivative that acts as an angiotensin II type 1 receptor antagonist. It is used in the management of HYPERTENSION, and in the treatment of kidney disease.

Therapeutic Applications

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

Irbesartan-Hydrochlorothiazide

Generic Formulation: Irbesartan/HydrochlorothiazideSpecialty: Cardiology
Provider Metrics Summary
Total Claims 13
30-Day Fills 39.0
Days Supply 1,170
PR State Average Benchmarks
Peer Average Claims56.0
Peer Average 30-Day Fills115.1
Peer Average Days Supply3,450
Highly Conservative Utilization

This provider demonstrates a highly selective approach to this formula, recording 76.8% less volume than the regional standard for practitioners inside PR. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $578.77 across this reporting matrix range.

Provider Avg Cost Per Claim

$44.52

State Avg Cost Per Claim

$32.36

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 drug is used to treat high blood pressure (hypertension). Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. This product contains two medications: irbesartan and hydrochlorothiazide. Irbesartan is an angiotensin receptor blocker (ARB) and works by relaxing blood vessels so that blood can flow more easily. Hydrochlorothiazide is a water pill (diuretic) that causes you to make more urine, which helps your body get rid of extra salt and water.

Isosorbide Mononitrate Er

Generic Formulation: Isosorbide MononitrateSpecialty: Cardiology
Provider Metrics Summary
Total Claims 17
30-Day Fills 51.0
Days Supply 1,530
PR State Average Benchmarks
Peer Average Claims62.0
Peer Average 30-Day Fills107.1
Peer Average Days Supply3,203
Highly Conservative Utilization

This provider demonstrates a highly selective approach to this formula, recording 72.6% less volume than the regional standard for practitioners inside PR. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $297.03 across this reporting matrix range.

Provider Avg Cost Per Claim

$17.47

State Avg Cost Per Claim

$13.71

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.

Levothyroxine Sodium

Generic Formulation: Levothyroxine SodiumSpecialty: Cardiology
Provider Metrics Summary
Total Claims 34
30-Day Fills 100.0
Days Supply 3,000
PR State Average Benchmarks
Peer Average Claims187.0
Peer Average 30-Day Fills331.5
Peer Average Days Supply9,904
Highly Conservative Utilization

This provider demonstrates a highly selective approach to this formula, recording 81.8% less volume than the regional standard for practitioners inside PR. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $948.31 across this reporting matrix range.

Provider Avg Cost Per Claim

$27.89

State Avg Cost Per Claim

$17.59

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

The major hormone derived from the thyroid gland. Thyroxine is synthesized via the iodination of tyrosines (MONOIODOTYROSINE) and the coupling of iodotyrosines (DIIODOTYROSINE) in the THYROGLOBULIN. Thyroxine is released from thyroglobulin by proteolysis and secreted into the blood. Thyroxine is peripherally deiodinated to form TRIIODOTHYRONINE which exerts a broad spectrum of stimulatory effects on cell metabolism.

Therapeutic Applications

Levothyroxine is used to treat an underactive thyroid (hypothyroidism). It replaces or provides more thyroid hormone, which is normally produced by the thyroid gland. Low thyroid hormone levels can occur naturally or when the thyroid gland is injured by radiation/medications or removed by surgery. Having enough thyroid hormone is important for maintaining normal mental and physical activity. In children, having enough thyroid hormone is important for normal mental and physical development. This medication is also used to treat other types of thyroid disorders (such as thyroid cancer). This medication should not be used to treat infertility unless it is caused by low thyroid hormone levels.

Lisinopril

Generic Formulation: LisinoprilSpecialty: Cardiology
Provider Metrics Summary
Total Claims 118
30-Day Fills 350.0
Days Supply 10,500
PR State Average Benchmarks
Peer Average Claims158.0
Peer Average 30-Day Fills310.8
Peer Average Days Supply9,303
Conservative Utilization

This provider writes prescriptions for this formulation 25.3% less frequently than the standard regional baseline metric for practitioners inside PR. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $792.03 across this reporting matrix range.

Provider Avg Cost Per Claim

$6.71

State Avg Cost Per Claim

$5.59

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

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.

Lisinopril-Hydrochlorothiazide

Generic Formulation: Lisinopril/HydrochlorothiazideSpecialty: Cardiology
Provider Metrics Summary
Total Claims 14
30-Day Fills 42.0
Days Supply 1,260
PR State Average Benchmarks
Peer Average Claims35.0
Peer Average 30-Day Fills72.9
Peer Average Days Supply2,185
Highly Conservative Utilization

This provider demonstrates a highly selective approach to this formula, recording 60.0% less volume than the regional standard for practitioners inside PR. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $140.79 across this reporting matrix range.

Provider Avg Cost Per Claim

$10.06

State Avg Cost Per Claim

$8.84

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 high blood pressure. Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. This product contains two medications: lisinopril and hydrochlorothiazide. Lisinopril is an ACE inhibitor and works by relaxing blood vessels so that blood can flow more easily. Hydrochlorothiazide is a water pill (diuretic) that causes you to make more urine, which helps your body get rid of extra salt and water. This product is used when one drug is not controlling your blood pressure. Your doctor may direct you to take the individual medications first, and then switch you to this combination product. Do not continue taking the individual medications (lisinopril and/or hydrochlorothiazide) after you start this medication.

Losartan Potassium

Generic Formulation: Losartan PotassiumSpecialty: Cardiology
Provider Metrics Summary
Total Claims 228
30-Day Fills 660.0
Days Supply 19,800
PR State Average Benchmarks
Peer Average Claims241.0
Peer Average 30-Day Fills479.1
Peer Average Days Supply14,345
Standard Average Utilization

This provider's prescribing patterns for this therapeutic formulation sit directly in line with standard baseline averages across PR. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $4,737.28 across this reporting matrix range.

Provider Avg Cost Per Claim

$20.78

State Avg Cost Per Claim

$17.23

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.

Losartan-Hydrochlorothiazide

Generic Formulation: Losartan/HydrochlorothiazideSpecialty: Cardiology
Provider Metrics Summary
Total Claims 70
30-Day Fills 198.0
Days Supply 5,940
PR State Average Benchmarks
Peer Average Claims68.0
Peer Average 30-Day Fills143.1
Peer Average Days Supply4,287
Standard Average Utilization

This provider's prescribing patterns for this therapeutic formulation sit directly in line with standard baseline averages across PR. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $1,858.22 across this reporting matrix range.

Provider Avg Cost Per Claim

$26.55

State Avg Cost Per Claim

$23.64

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.

Therapeutic Applications

This drug is used to treat high blood pressure. 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. This product contains two medications: losartan and hydrochlorothiazide. Losartan is an angiotensin receptor blocker (ARB) and works by relaxing blood vessels so that blood can flow more easily. Hydrochlorothiazide is a water pill (diuretic) that causes you to make more urine, which helps your body get rid of extra salt and water.

Meclizine Hcl

Generic Formulation: Meclizine HclSpecialty: Cardiology
Provider Metrics Summary
Total Claims 20
30-Day Fills 22.0
Days Supply 560
PR State Average Benchmarks
Peer Average Claims39.0
Peer Average 30-Day Fills40.7
Peer Average Days Supply971
Conservative Utilization

This provider writes prescriptions for this formulation 48.7% less frequently than the standard regional baseline metric for practitioners inside PR. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $119.02 across this reporting matrix range.

Provider Avg Cost Per Claim

$5.95

State Avg Cost Per Claim

$7.83

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

Meclizine is an antihistamine that is used to prevent and treat nausea, vomiting, and dizziness caused by motion sickness. It may also be used to reduce dizziness and loss of balance (vertigo) caused by inner ear problems.

Metformin Hcl

Generic Formulation: Metformin HclSpecialty: Cardiology
Provider Metrics Summary
Total Claims 60
30-Day Fills 168.0
Days Supply 5,040
PR State Average Benchmarks
Peer Average Claims220.0
Peer Average 30-Day Fills438.2
Peer Average Days Supply13,110
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 PR. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $327.47 across this reporting matrix range.

Provider Avg Cost Per Claim

$5.46

State Avg Cost Per Claim

$6.12

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 biguanide hypoglycemic agent used in the treatment of non-insulin-dependent diabetes mellitus not responding to dietary modification. Metformin improves glycemic control by improving insulin sensitivity and decreasing intestinal absorption of glucose. (From Martindale, The Extra Pharmacopoeia, 30th ed, p289)

Therapeutic Applications

Metformin is used with a proper diet and exercise program and possibly with other medications to control high blood sugar. It is used in patients with type 2 diabetes. Controlling high blood sugar helps prevent kidney damage, blindness, nerve problems, loss of limbs, and sexual function problems. Proper control of diabetes may also lessen your risk of a heart attack or stroke. Metformin works by helping to restore your body's proper response to the insulin you naturally produce. It also decreases the amount of sugar that your liver makes and that your stomach/intestines absorb.

Metoprolol Succinate

Generic Formulation: Metoprolol SuccinateSpecialty: Cardiology
Provider Metrics Summary
Total Claims 219
30-Day Fills 643.0
Days Supply 19,290
PR State Average Benchmarks
Peer Average Claims165.0
Peer Average 30-Day Fills316.7
Peer Average Days Supply9,479
Elevated Utilization

This provider maintains an active emphasis on this therapeutic option, recording 32.7% more claims than the standard regional baseline profile for PR. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $4,114.00 across this reporting matrix range.

Provider Avg Cost Per Claim

$18.79

State Avg Cost Per Claim

$19.18

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 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: Cardiology
Provider Metrics Summary
Total Claims 54
30-Day Fills 159.0
Days Supply 4,770
PR State Average Benchmarks
Peer Average Claims70.0
Peer Average 30-Day Fills129.9
Peer Average Days Supply3,880
Standard Average Utilization

This provider's prescribing patterns for this therapeutic formulation sit directly in line with standard baseline averages across PR. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $382.51 across this reporting matrix range.

Provider Avg Cost Per Claim

$7.08

State Avg Cost Per Claim

$5.67

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.

Nifedipine Er

Generic Formulation: NifedipineSpecialty: Cardiology
Provider Metrics Summary
Total Claims 29
30-Day Fills 81.0
Days Supply 2,430
PR State Average Benchmarks
Peer Average Claims47.0
Peer Average 30-Day Fills83.1
Peer Average Days Supply2,485
Conservative Utilization

This provider writes prescriptions for this formulation 38.3% less frequently than the standard regional baseline metric for practitioners inside PR. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $1,269.99 across this reporting matrix range.

Provider Avg Cost Per Claim

$43.79

State Avg Cost Per Claim

$28.00

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 potent vasodilator agent with calcium antagonistic action. It is a useful anti-anginal agent that also lowers blood pressure.

Therapeutic Applications

This medication is used to prevent certain types of chest pain (angina). It may allow you to exercise more and decrease the frequency of angina attacks. Nifedipine belongs to a class of medications known as calcium channel blockers. It works by relaxing blood vessels so blood can flow more easily. This medication must be taken regularly to be effective. 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. Consult your doctor or pharmacist for details. Older adults should discuss the risks and benefits of this medication with their doctor or pharmacist, as well as other possibly safer forms of nifedipine (such as the long-acting tablets).

Omega-3 Acid Ethyl Esters

Generic Formulation: Omega-3 Acid Ethyl EstersSpecialty: Cardiology
Provider Metrics Summary
Total Claims 13
30-Day Fills 34.3
Days Supply 1,028
PR State Average Benchmarks
Peer Average Claims61.0
Peer Average 30-Day Fills97.0
Peer Average Days Supply2,889
Highly Conservative Utilization

This provider demonstrates a highly selective approach to this formula, recording 78.7% less volume than the regional standard for practitioners inside PR. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $818.10 across this reporting matrix range.

Provider Avg Cost Per Claim

$62.93

State Avg Cost Per Claim

$66.24

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

Omega-3 acid ethyl esters, a type of fat found in fish oil, is used along with diet and exercise to help lower levels of a certain blood fat (triglyceride). It may also raise good cholesterol (HDL). In general, this drug is used after your blood fat levels have not been fully controlled by non-drug treatments (such as diet changes, exercise, decreasing alcohol intake, weight loss if overweight, controlling blood sugar if diabetic, and regulating your thyroid hormone levels). Lowering triglycerides and increasing good cholesterol may help decrease the risk for strokes and heart attacks. Omega-3 acid ethyl esters are thought to work by decreasing the amount of triglyceride the body makes.

Omeprazole

Generic Formulation: OmeprazoleSpecialty: Cardiology
Provider Metrics Summary
Total Claims 16
30-Day Fills 30.0
Days Supply 900
PR State Average Benchmarks
Peer Average Claims174.0
Peer Average 30-Day Fills213.0
Peer Average Days Supply6,317
Highly Conservative Utilization

This provider demonstrates a highly selective approach to this formula, recording 90.8% less volume than the regional standard for practitioners inside PR. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $106.27 across this reporting matrix range.

Provider Avg Cost Per Claim

$6.64

State Avg Cost Per Claim

$6.83

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: Cardiology
Provider Metrics Summary
Total Claims 40
30-Day Fills 42.0
Days Supply 1,260
PR State Average Benchmarks
Peer Average Claims144.0
Peer Average 30-Day Fills178.4
Peer Average Days Supply5,296
Highly Conservative Utilization

This provider demonstrates a highly selective approach to this formula, recording 72.2% less volume than the regional standard for practitioners inside PR. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $224.10 across this reporting matrix range.

Provider Avg Cost Per Claim

$5.60

State Avg Cost Per Claim

$8.05

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

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).

Pravastatin Sodium

Generic Formulation: Pravastatin SodiumSpecialty: Cardiology
Provider Metrics Summary
Total Claims 11
30-Day Fills 33.0
Days Supply 990
PR State Average Benchmarks
Peer Average Claims51.0
Peer Average 30-Day Fills103.3
Peer Average Days Supply3,092
Highly Conservative Utilization

This provider demonstrates a highly selective approach to this formula, recording 78.4% less volume than the regional standard for practitioners inside PR. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $182.62 across this reporting matrix range.

Provider Avg Cost Per Claim

$16.60

State Avg Cost Per Claim

$14.71

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 antilipemic fungal metabolite isolated from cultures of Nocardia autotrophica. It acts as a competitive inhibitor of HMG CoA reductase (HYDROXYMETHYLGLUTARYL COA REDUCTASES).

Therapeutic Applications

Pravastatin 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.

Ramipril

Generic Formulation: RamiprilSpecialty: Cardiology
Provider Metrics Summary
Total Claims 13
30-Day Fills 39.0
Days Supply 1,170
PR State Average Benchmarks
Peer Average Claims39.0
Peer Average 30-Day Fills77.5
Peer Average Days Supply2,321
Highly Conservative Utilization

This provider demonstrates a highly selective approach to this formula, recording 66.7% less volume than the regional standard for practitioners inside PR. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $125.46 across this reporting matrix range.

Provider Avg Cost Per Claim

$9.65

State Avg Cost Per Claim

$10.32

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 long-acting angiotensin-converting enzyme inhibitor. It is a prodrug that is transformed in the liver to its active metabolite ramiprilat.

Therapeutic Applications

Ramipril is used to treat high blood pressure (hypertension). Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. Ramipril is also used to improve survival after a heart attack. It may also be used in high risk patients (such as patients with heart disease/diabetes) to help prevent heart attacks and strokes. This medication may also be used to treat heart failure in patients who have had a recent heart attack. Ramipril is an ACE inhibitor and works by relaxing blood vessels so that blood can flow more easily.

Rosuvastatin Calcium

Generic Formulation: Rosuvastatin CalciumSpecialty: Cardiology
Provider Metrics Summary
Total Claims 63
30-Day Fills 189.0
Days Supply 5,670
PR State Average Benchmarks
Peer Average Claims143.0
Peer Average 30-Day Fills288.6
Peer Average Days Supply8,650
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 PR. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $925.48 across this reporting matrix range.

Provider Avg Cost Per Claim

$14.69

State Avg Cost Per Claim

$15.28

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

Clinical Summary

A 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.

Simvastatin

Generic Formulation: SimvastatinSpecialty: Cardiology
Provider Metrics Summary
Total Claims 174
30-Day Fills 520.0
Days Supply 15,600
PR State Average Benchmarks
Peer Average Claims214.0
Peer Average 30-Day Fills436.6
Peer Average Days Supply13,074
Standard Average Utilization

This provider's prescribing patterns for this therapeutic formulation sit directly in line with standard baseline averages across PR. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $1,124.80 across this reporting matrix range.

Provider Avg Cost Per Claim

$6.46

State Avg Cost Per Claim

$6.36

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 derivative of LOVASTATIN and potent competitive inhibitor of 3-hydroxy-3-methylglutaryl coenzyme A reductase (HYDROXYMETHYLGLUTARYL COA REDUCTASES), which is the rate-limiting enzyme in cholesterol biosynthesis. It may also interfere with steroid hormone production. Due to the induction of hepatic LDL RECEPTORS, it increases breakdown of LDL CHOLESTEROL.

Therapeutic Applications

Simvastatin 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.

Spironolactone

Generic Formulation: SpironolactoneSpecialty: Cardiology
Provider Metrics Summary
Total Claims 18
30-Day Fills 54.0
Days Supply 1,620
PR State Average Benchmarks
Peer Average Claims44.0
Peer Average 30-Day Fills74.7
Peer Average Days Supply2,229
Highly Conservative Utilization

This provider demonstrates a highly selective approach to this formula, recording 59.1% less volume than the regional standard for practitioners inside PR. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $150.38 across this reporting matrix range.

Provider Avg Cost Per Claim

$8.35

State Avg Cost Per Claim

$8.56

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).

Synthroid

Generic Formulation: Levothyroxine SodiumSpecialty: Cardiology
Provider Metrics Summary
Total Claims 26
30-Day Fills 66.0
Days Supply 1,980
PR State Average Benchmarks
Peer Average Claims214.0
Peer Average 30-Day Fills350.5
Peer Average Days Supply10,488
Highly Conservative Utilization

This provider demonstrates a highly selective approach to this formula, recording 87.9% less volume than the regional standard for practitioners inside PR. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $2,946.71 across this reporting matrix range.

Provider Avg Cost Per Claim

$113.34

State Avg Cost Per Claim

$70.11

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

The major hormone derived from the thyroid gland. Thyroxine is synthesized via the iodination of tyrosines (MONOIODOTYROSINE) and the coupling of iodotyrosines (DIIODOTYROSINE) in the THYROGLOBULIN. Thyroxine is released from thyroglobulin by proteolysis and secreted into the blood. Thyroxine is peripherally deiodinated to form TRIIODOTHYRONINE which exerts a broad spectrum of stimulatory effects on cell metabolism.

Therapeutic Applications

Levothyroxine is used to treat an underactive thyroid (hypothyroidism). It replaces or provides more thyroid hormone, which is normally produced by the thyroid gland. Low thyroid hormone levels can occur naturally or when the thyroid gland is injured by radiation/medications or removed by surgery. Having enough thyroid hormone is important for maintaining normal mental and physical activity. In children, having enough thyroid hormone is important for normal mental and physical development. This medication is also used to treat other types of thyroid disorders (such as thyroid cancer). This medication should not be used to treat infertility unless it is caused by low thyroid hormone levels.

Tamsulosin Hcl

Generic Formulation: Tamsulosin HclSpecialty: Cardiology
Provider Metrics Summary
Total Claims 16
30-Day Fills 44.0
Days Supply 1,320
PR State Average Benchmarks
Peer Average Claims118.0
Peer Average 30-Day Fills201.2
Peer Average Days Supply6,003
Highly Conservative Utilization

This provider demonstrates a highly selective approach to this formula, recording 86.4% less volume than the regional standard for practitioners inside PR. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $189.20 across this reporting matrix range.

Provider Avg Cost Per Claim

$11.83

State Avg Cost Per Claim

$11.80

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.

Therapeutic Applications

Tamsulosin is used by men to treat the symptoms of an enlarged prostate (benign prostatic hyperplasia-BPH). It does not shrink the prostate, but it works by relaxing the muscles in the prostate and the bladder. This helps to relieve symptoms of BPH such as difficulty in beginning the flow of urine, weak stream, and the need to urinate often or urgently (including during the middle of the night). Tamsulosin belongs to a class of drugs known as alpha blockers. Do not use this medication to treat high blood pressure.

Valsartan

Generic Formulation: ValsartanSpecialty: Cardiology
Provider Metrics Summary
Total Claims 16
30-Day Fills 48.0
Days Supply 1,440
PR State Average Benchmarks
Peer Average Claims42.0
Peer Average 30-Day Fills81.8
Peer Average Days Supply2,449
Highly Conservative Utilization

This provider demonstrates a highly selective approach to this formula, recording 61.9% less volume than the regional standard for practitioners inside PR. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $886.44 across this reporting matrix range.

Provider Avg Cost Per Claim

$55.40

State Avg Cost Per Claim

$39.27

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.

Clinical Summary

A tetrazole derivative and ANGIOTENSIN II TYPE 1 RECEPTOR BLOCKER that is used to treat HYPERTENSION.

Therapeutic Applications

Valsartan is used to treat high blood pressure and heart failure. It is also used to improve the chance of living longer after a heart attack. In people with heart failure, it may also lower the chance of having to go to the hospital for heart failure. Valsartan belongs to a class of drugs called angiotensin receptor blockers (ARBs). It works by relaxing blood vessels so that blood can flow more easily. Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems.

Valsartan-Hydrochlorothiazide

Generic Formulation: Valsartan/HydrochlorothiazideSpecialty: Cardiology
Provider Metrics Summary
Total Claims 12
30-Day Fills 34.0
Days Supply 1,020
PR State Average Benchmarks
Peer Average Claims39.0
Peer Average 30-Day Fills79.0
Peer Average Days Supply2,369
Highly Conservative Utilization

This provider demonstrates a highly selective approach to this formula, recording 69.2% less volume than the regional standard for practitioners inside PR. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $621.28 across this reporting matrix range.

Provider Avg Cost Per Claim

$51.77

State Avg Cost Per Claim

$39.85

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 drug is used to treat high blood pressure. Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. This product contains two medications: valsartan and hydrochlorothiazide. Valsartan is an angiotensin receptor blocker (ARB) and works by relaxing blood vessels so that blood can flow more easily. Hydrochlorothiazide is a water pill (diuretic) that causes you to make more urine, which helps your body get rid of extra salt and water.

Verapamil Hcl

Generic Formulation: Verapamil HclSpecialty: Cardiology
Provider Metrics Summary
Total Claims 13
30-Day Fills 33.0
Days Supply 990
PR State Average Benchmarks
Peer Average Claims20.0
Peer Average 30-Day Fills33.7
Peer Average Days Supply1,008
Conservative Utilization

This provider writes prescriptions for this formulation 35.0% less frequently than the standard regional baseline metric for practitioners inside PR. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $213.43 across this reporting matrix range.

Provider Avg Cost Per Claim

$16.42

State Avg Cost Per Claim

$10.63

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

Verapamil is used to treat high blood pressure. Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. Verapamil belongs to a class of drugs known as calcium channel blockers. It works by relaxing blood vessels so blood can flow more easily. Verapamil may also lower your heart rate.

Warfarin Sodium

Generic Formulation: Warfarin SodiumSpecialty: Cardiology
Provider Metrics Summary
Total Claims 18
30-Day Fills 48.0
Days Supply 1,440
PR State Average Benchmarks
Peer Average Claims37.0
Peer Average 30-Day Fills52.3
Peer Average Days Supply1,538
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 PR. Gross expenditures recorded under Medicare program tracking definitions for this provider calculate to an estimated aggregate of $429.05 across this reporting matrix range.

Provider Avg Cost Per Claim

$23.84

State Avg Cost Per Claim

$10.65

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

An anticoagulant that acts by inhibiting the synthesis of vitamin K-dependent coagulation factors. Warfarin is indicated for the prophylaxis and/or treatment of venous thrombosis and its extension, pulmonary embolism, and atrial fibrillation with embolization. It is also used as an adjunct in the prophylaxis of systemic embolism after myocardial infarction. Warfarin is also used as a rodenticide.

Therapeutic Applications

This medication is used to treat blood clots (such as in deep vein thrombosis-DVT or pulmonary embolus-PE) and/or to prevent new clots from forming in your body. Preventing harmful blood clots helps to reduce the risk of a stroke or heart attack. Conditions that increase your risk of developing blood clots include a certain type of irregular heart rhythm (atrial fibrillation), heart valve replacement, recent heart attack, and certain surgeries (such as hip/knee replacement). Warfarin is commonly called a blood thinner, but the more correct term is anticoagulant. It helps to keep blood flowing smoothly in your body by decreasing the amount of certain substances (clotting proteins) in your blood.

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. ROBERT A ENGEL MD provides transparency into local medical care patterns within Juana Diaz, PR.

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 **Cardiovascular Disease** 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.