Payment overview · 2025
General Payments
$91.56
5 reported records · 2 companies
Healthcare provider profile · identity verified
Nancy Lu Howe, ARNP
Physician Assistants & Advanced Practice Nursing Providers|Nurse Practitioner|Psychiatric/Mental Health · SPENCER, IA · NPI 1346298221
Verified facts
What the public records show
CMS Open Payments records show Nancy Lu Howe, ARNP received $91.56 in general payments during 2025 across 5 reported records.
ABBVIE INC. accounted for 60.0% of that reported general-payment amount.
The Open Payments records used for this analysis explicitly named 2 associated products.
A separate comparison found the same explicitly named product in public Medicare Part D data: Rexulti, Vraylar.
ABBVIE INC. reported payments to this doctor in 2025. Across the 2025 Open Payments General Payment records loaded for this analysis, that same reporting entity reported VRAYLAR as an associated drug or biological on 377741 records involving 62704 distinct recipient NPIs. Public Medicare Part D data also shows 84 claims for Vraylar by this doctor in 2024.
Otsuka America Pharmaceutical, Inc. reported payments to this doctor in 2025. Across the 2025 Open Payments General Payment records loaded for this analysis, that same reporting entity reported REXULTI as an associated drug or biological on 160756 records involving 46288 distinct recipient NPIs. Public Medicare Part D data also shows 15 claims for Rexulti by this doctor in 2024.
These records do not establish that a payment influenced prescribing or medical care.
Separate record types
Research & Ownership
Research Payments (direct recipient): not present in the loaded data
Associated Research Funding (for example, named PI): not present in the loaded data
Ownership / Investment: not present in the loaded data
These categories are never added into the General Payments headline. Associated research funding must not be described as money the doctor personally received unless the source record supports that conclusion.
Who paid this doctor?
Companies in 2025 General Payments
| Reported company | Canonical company | Amount | Share | Records | Year |
|---|---|---|---|---|---|
| ABBVIE INC. | Unresolved — no canonical attribution shown | $54.89 | 60.0% | 3 | 2025 |
| Otsuka America Pharmaceutical, Inc. | Unresolved — no canonical attribution shown | $36.67 | 40.0% | 2 | 2025 |
What were the payments for?
Payment categories
| Category | Amount | Records |
|---|---|---|
| Food and Beverage | $91.56 | 5 |
A meal, consulting fee, royalty, and travel payment describe different kinds of reported relationships and should not be interpreted as equivalent.
Analysis 1 · Payment-linked products
Products named in Open Payments records
| Reported product | Type | Reported company | Related amount* | Records | Year |
|---|---|---|---|---|---|
| VRAYLAR Normalized: vraylar |
Drug | ABBVIE INC. | $54.89 | 3 | 2025 |
Source payment records
|
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| REXULTI Normalized: rexulti |
Drug | Otsuka America Pharmaceutical, Inc. | $36.67 | 2 | 2025 |
Source payment records
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* Product-associated amounts are non-additive because one payment record may name more than one product.
These products were named on specific Open Payments records. A named product does not show that the payment influenced treatment or prescribing.
Public prescribing for products named in payments
| Open Payments product | Payment year | Part D brand | Part D year | Claims | Match method | Source |
|---|---|---|---|---|---|---|
| REXULTI rexulti |
2025 | Rexulti | 2024 | 15 Beneficiary count suppressed |
exact normalized | Medicare Part D |
| VRAYLAR vraylar |
2025 | Vraylar | 2024 | 84 | exact normalized | Medicare Part D |
The presence of the same drug in both datasets does not show that a payment caused or influenced a prescription.
Analysis 2 · Same-company prescribing overlap
Drugs reported in other payments from the same company that also appear in Medicare Part D
This analysis is independent from products named on this doctor’s individual payment records. A row appears only when the exact Open Payments reporting entity paid this doctor, that same reporting entity reported the drug or biological on at least 10 loaded General Payment records involving at least 2 distinct recipient NPIs, and this doctor has the same non-generic brand in public Part D data. This does not mean the company owns or manufactures the drug.
| Paying company | Payment year | Drug reported by same entity | Open Payments evidence | Part D | Claims | Beneficiaries |
|---|---|---|---|---|---|---|
| ABBVIE INC. Exact reporting entity; no affiliate inference |
2025 | VRAYLAR open payments reported associated product |
CMS Open Payments — General Payments 377741 supporting records · 62704 recipient NPIs · example record 1201352550 |
Vraylar · 2024 Exact normalized brand match · 1 Part D row |
84 | 11 |
| Otsuka America Pharmaceutical, Inc. Exact reporting entity; no affiliate inference |
2025 | REXULTI open payments reported associated product |
CMS Open Payments — General Payments 160756 supporting records · 46288 recipient NPIs · example record 1227267708 |
Rexulti · 2024 Exact normalized brand match · 1 Part D row |
15 | suppressed by CMS |
These facts do not show that a payment was for the drug, that the company owns or manufactures the drug, or that a payment caused or influenced prescribing.
Public Medicare Part D data
Provider-and-drug rows loaded for 2024
| Brand | Generic | Claims | Beneficiaries |
|---|---|---|---|
| Duloxetine Hcl | Duloxetine Hcl | 321 | 53 |
| Trazodone Hcl | Trazodone Hcl | 308 | 59 |
| Bupropion Xl | Bupropion Hcl | 254 | 49 |
| Clonazepam | Clonazepam | 220 | 33 |
| Escitalopram Oxalate | Escitalopram Oxalate | 208 | 31 |
| Lamotrigine | Lamotrigine | 200 | 35 |
| Lorazepam | Lorazepam | 191 | 42 |
| Sertraline Hcl | Sertraline Hcl | 182 | 34 |
| Quetiapine Fumarate | Quetiapine Fumarate | 175 | 27 |
| Risperidone | Risperidone | 175 | 12 |
| Alprazolam | Alprazolam | 141 | 23 |
| Zolpidem Tartrate | Zolpidem Tartrate | 139 | 25 |
| Venlafaxine Hcl Er | Venlafaxine Hcl | 128 | 26 |
| Aripiprazole | Aripiprazole | 127 | 20 |
| Diazepam | Diazepam | 123 | 22 |
| Hydroxyzine Hcl | Hydroxyzine Hcl | 110 | 19 |
| Fluoxetine Hcl | Fluoxetine Hcl | 105 | 15 |
| Paroxetine Hcl | Paroxetine Hcl | 101 | 11 |
| Buspirone Hcl | Buspirone Hcl | 92 | 16 |
| Methylphenidate Hcl | Methylphenidate Hcl | 92 | 14 |
| Vraylar | Cariprazine Hcl | 84 | 11 |
| Gabapentin | Gabapentin | 81 | 19 |
| Divalproex Sodium Er | Divalproex Sodium | 76 | suppressed |
| Mirtazapine | Mirtazapine | 60 | 14 |
| Olanzapine | Olanzapine | 54 | suppressed |
| Citalopram Hbr | Citalopram Hydrobromide | 53 | 12 |
| Guanfacine Hcl | Guanfacine Hcl | 50 | suppressed |
| Dextroamphetamine-Amphetamine | Dextroamphetamine/Amphetamine | 49 | suppressed |
| Amitriptyline Hcl | Amitriptyline Hcl | 43 | suppressed |
| Guanfacine Hcl Er | Guanfacine Hcl | 43 | suppressed |
| Divalproex Sodium | Divalproex Sodium | 37 | suppressed |
| Benztropine Mesylate | Benztropine Mesylate | 35 | suppressed |
| Methylphenidate Er | Methylphenidate Hcl | 33 | suppressed |
| Nortriptyline Hcl | Nortriptyline Hcl | 31 | suppressed |
| Temazepam | Temazepam | 30 | suppressed |
| Vyvanse | Lisdexamfetamine Dimesylate | 30 | suppressed |
| Desvenlafaxine Succinate Er | Desvenlafaxine Succinate | 29 | suppressed |
| Doxepin Hcl | Doxepin Hcl | 29 | suppressed |
| Topiramate | Topiramate | 29 | suppressed |
| Clonidine Hcl | Clonidine Hcl | 28 | suppressed |
| Propranolol Hcl | Propranolol Hcl | 28 | suppressed |
| Dextroamphetamine-Amphet Er | Dextroamphetamine/Amphetamine | 26 | suppressed |
| Fluvoxamine Maleate | Fluvoxamine Maleate | 26 | suppressed |
| Lisdexamfetamine Dimesylate | Lisdexamfetamine Dimesylate | 26 | suppressed |
| Clomipramine Hcl | Clomipramine Hcl | 25 | suppressed |
| Donepezil Hcl | Donepezil Hcl | 24 | suppressed |
| Prazosin Hcl | Prazosin Hcl | 22 | suppressed |
| Quetiapine Fumarate Er | Quetiapine Fumarate | 21 | suppressed |
| Trintellix | Vortioxetine Hydrobromide | 20 | suppressed |
| Zolpidem Tartrate Er | Zolpidem Tartrate | 20 | suppressed |
| Eszopiclone | Eszopiclone | 18 | suppressed |
| Imipramine Hcl | Imipramine Hcl | 18 | suppressed |
| Memantine Hcl | Memantine Hcl | 18 | suppressed |
| Modafinil | Modafinil | 18 | suppressed |
| Lurasidone Hcl | Lurasidone Hcl | 16 | suppressed |
| Namzaric | Memantine Hcl/Donepezil Hcl | 16 | suppressed |
| Paroxetine Er | Paroxetine Hcl | 16 | suppressed |
| Ropinirole Hcl | Ropinirole Hcl | 16 | suppressed |
| Rexulti | Brexpiprazole | 15 | suppressed |
| Zaleplon | Zaleplon | 13 | suppressed |
| Dextroamphetamine Sulfate Er | Dextroamphetamine Sulfate | 12 | suppressed |
| Lamictal | Lamotrigine | 12 | suppressed |
| Lexapro | Escitalopram Oxalate | 12 | suppressed |
| Dexmethylphenidate Hcl | Dexmethylphenidate Hcl | 11 | suppressed |
| Dexmethylphenidate Hcl Er | Dexmethylphenidate Hcl | 11 | suppressed |
Timeline
Payment and prescribing data by year
Open Payments and Medicare Part D may refer to different years. They are shown separately rather than aligned as if they describe the same period.
| Year | General Payments | Main payer | Explicit products | Company overlaps | Part D coverage |
|---|---|---|---|---|---|
| 2025 | $91.56 · 5 records | ABBVIE INC. | REXULTI, VRAYLAR | 2 | — |
| 2024 | — | — | — | — | Complete |
Questions to ask
Questions you could discuss with your doctor
- What role, if any, does Rexulti play in your treatment recommendations for me?
- How do you evaluate evidence when you have a financial relationship with ABBVIE INC.?
- Are there reasonable alternatives I should understand when we discuss treatment options?
- How should I interpret the industry-payment records shown here in the context of my care?
These are general questions generated from reviewed templates. They are not personalized medical advice.
Sources and limitations
How to read this page
- Payment and Medicare prescribing data can cover different years; every comparison shows both years explicitly.
- Part D does not represent a doctor’s entire practice; it excludes many patients and is subject to CMS public-release thresholds.
- Company–drug relationships must have an auditable source, a precise relationship type, and a valid evidence period. Unresolved mappings are not published.
- Generic drug claims are not attributed to a specific manufacturer without manufacturer-level evidence.
- When a source extract is incomplete, missing rows are never treated as proof of no payments or no prescriptions.
Loaded source releases
| Dataset | Year | Publication | Source |
|---|---|---|---|
| CMS Open Payments — General Payments | 2025 | 2026-06-30 | Original source |
| Medicare Part D Prescribers by Provider and Drug | 2024 | 2026-05-06 | Original source |
| NPPES Data Dissemination V2 | current / reference data | 2026-08-10 | Original source |
Full methodology · Questions & answers · Report a possible error