Payment overview · 2025
General Payments
$58.35
3 reported records · 3 companies
Healthcare provider profile · identity verified
April Ann Estelle
Physician Assistants & Advanced Practice Nursing Providers|Nurse Practitioner|Family · SPOKANE, WA · NPI 1386925949
Verified facts
What the public records show
CMS Open Payments records show April Ann Estelle received $58.35 in general payments during 2025 across 3 reported records.
Dexcom, Inc. accounted for 41.1% of that reported general-payment amount.
The Open Payments records used for this analysis explicitly named 4 associated products.
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 SYNTHROID as an associated drug or biological on 10655 records involving 4881 distinct recipient NPIs. Public Medicare Part D data also shows 17 claims for Synthroid 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 |
|---|---|---|---|---|---|
| Dexcom, Inc. | Unresolved — no canonical attribution shown | $23.96 | 41.1% | 1 | 2025 |
| ABBVIE INC. | Unresolved — no canonical attribution shown | $17.73 | 30.4% | 1 | 2025 |
| AstraZeneca Pharmaceuticals LP | Unresolved — no canonical attribution shown | $16.66 | 28.6% | 1 | 2025 |
What were the payments for?
Payment categories
| Category | Amount | Records |
|---|---|---|
| Food and Beverage | $58.35 | 3 |
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 |
|---|---|---|---|---|---|
| Dexcom G6 Transmitter Normalized: dexcom g6 transmitter |
Medical Supply | Dexcom, Inc. | $23.96 | 1 | 2025 |
Source payment records
|
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| QULIPTA Normalized: qulipta |
Drug | ABBVIE INC. | $17.73 | 1 | 2025 |
Source payment records
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| UBRELVY Normalized: ubrelvy |
Drug | ABBVIE INC. | $17.73 | 1 | 2025 |
Source payment records
|
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| FARXIGA Normalized: farxiga |
Drug | AstraZeneca Pharmaceuticals LP | $16.66 | 1 | 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
No exact normalized or approved-alias overlap was found in the loaded Part D year. This does not mean the doctor never prescribed the product.
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 | SYNTHROID open payments reported associated product |
CMS Open Payments — General Payments 10655 supporting records · 4881 recipient NPIs · example record 1201352636 |
Synthroid · 2024 Exact normalized brand match · 1 Part D row |
17 | 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 |
|---|---|---|---|
| Atorvastatin Calcium | Atorvastatin Calcium | 186 | 43 |
| Levothyroxine Sodium | Levothyroxine Sodium | 183 | 46 |
| Amlodipine Besylate | Amlodipine Besylate | 132 | 26 |
| Lisinopril | Lisinopril | 115 | 32 |
| Losartan Potassium | Losartan Potassium | 113 | 32 |
| Hydrochlorothiazide | Hydrochlorothiazide | 108 | 24 |
| Omeprazole | Omeprazole | 99 | 22 |
| Gabapentin | Gabapentin | 80 | 21 |
| Rosuvastatin Calcium | Rosuvastatin Calcium | 77 | 24 |
| Tizanidine Hcl | Tizanidine Hcl | 71 | 26 |
| Fluticasone Propionate | Fluticasone Propionate | 70 | 28 |
| Metoprolol Succinate | Metoprolol Succinate | 66 | 12 |
| Zolpidem Tartrate | Zolpidem Tartrate | 60 | suppressed |
| Duloxetine Hcl | Duloxetine Hcl | 59 | suppressed |
| Albuterol Sulfate Hfa | Albuterol Sulfate | 57 | 21 |
| Simvastatin | Simvastatin | 56 | 11 |
| Tamsulosin Hcl | Tamsulosin Hcl | 50 | 12 |
| Sertraline Hcl | Sertraline Hcl | 48 | suppressed |
| Fluoxetine Hcl | Fluoxetine Hcl | 43 | suppressed |
| Potassium Chloride | Potassium Chloride | 41 | suppressed |
| Ozempic | Semaglutide | 39 | suppressed |
| Hydrocodone-Acetaminophen | Hydrocodone/Acetaminophen | 38 | 15 |
| Pantoprazole Sodium | Pantoprazole Sodium | 36 | suppressed |
| Citalopram Hbr | Citalopram Hydrobromide | 35 | suppressed |
| Metformin Hcl | Metformin Hcl | 34 | suppressed |
| Warfarin Sodium | Warfarin Sodium | 34 | suppressed |
| Azithromycin | Azithromycin | 33 | 25 |
| Olmesartan Medoxomil | Olmesartan Medoxomil | 33 | suppressed |
| Escitalopram Oxalate | Escitalopram Oxalate | 31 | suppressed |
| Meloxicam | Meloxicam | 30 | 13 |
| Ropinirole Hcl | Ropinirole Hcl | 29 | suppressed |
| Oxycodone Hcl | Oxycodone Hcl | 28 | 13 |
| Trazodone Hcl | Trazodone Hcl | 28 | 13 |
| Doxepin Hcl | Doxepin Hcl | 27 | suppressed |
| Arnuity Ellipta | Fluticasone Furoate | 25 | suppressed |
| Doxycycline Hyclate | Doxycycline Hyclate | 25 | 23 |
| Trelegy Ellipta | Fluticasone/Umeclidin/Vilanter | 25 | suppressed |
| Estradiol | Estradiol | 23 | suppressed |
| Tramadol Hcl | Tramadol Hcl | 23 | suppressed |
| Metformin Hcl Er | Metformin Hcl | 22 | suppressed |
| Furosemide | Furosemide | 21 | suppressed |
| Alprazolam | Alprazolam | 20 | suppressed |
| Xarelto | Rivaroxaban | 20 | suppressed |
| Cyclobenzaprine Hcl | Cyclobenzaprine Hcl | 19 | suppressed |
| Montelukast Sodium | Montelukast Sodium | 19 | suppressed |
| Acyclovir | Acyclovir | 18 | suppressed |
| Amitriptyline Hcl | Amitriptyline Hcl | 18 | suppressed |
| Clonidine Hcl | Clonidine Hcl | 18 | suppressed |
| Amoxicillin-Clavulanate Potass | Amoxicillin/Potassium Clav | 17 | 15 |
| Clopidogrel | Clopidogrel Bisulfate | 17 | suppressed |
| Lorazepam | Lorazepam | 17 | suppressed |
| Synthroid | Levothyroxine Sodium | 17 | suppressed |
| Acetaminophen-Codeine | Acetaminophen With Codeine | 16 | suppressed |
| Clonazepam | Clonazepam | 16 | suppressed |
| Donepezil Hcl | Donepezil Hcl | 16 | suppressed |
| Lisinopril-Hydrochlorothiazide | Lisinopril/Hydrochlorothiazide | 16 | suppressed |
| Spironolactone | Spironolactone | 16 | suppressed |
| Triamcinolone Acetonide | Triamcinolone Acetonide | 16 | suppressed |
| Triamterene-Hydrochlorothiazid | Triamterene/Hydrochlorothiazid | 16 | suppressed |
| Basaglar Kwikpen U-100 | Insulin Glargine,hum.Rec.Anlog | 15 | suppressed |
| Hydroxyzine Hcl | Hydroxyzine Hcl | 15 | suppressed |
| Ibuprofen | Ibuprofen | 15 | suppressed |
| Nitrofurantoin Mono-Macro | Nitrofurantoin Monohyd/M-Cryst | 15 | 14 |
| Quetiapine Fumarate | Quetiapine Fumarate | 15 | suppressed |
| Methadone Hcl | Methadone Hcl | 14 | suppressed |
| Pregabalin | Pregabalin | 14 | suppressed |
| Topiramate | Topiramate | 14 | suppressed |
| Venlafaxine Hcl Er | Venlafaxine Hcl | 14 | suppressed |
| Diltiazem 24hr Er (Cd) | Diltiazem Hcl | 13 | suppressed |
| Esomeprazole Magnesium | Esomeprazole Magnesium | 13 | suppressed |
| Finasteride | Finasteride | 13 | suppressed |
| Hydromorphone Hcl | Hydromorphone Hcl | 13 | suppressed |
| Prednisone | Prednisone | 13 | 12 |
| Verapamil Hcl | Verapamil Hcl | 13 | suppressed |
| Anoro Ellipta | Umeclidinium Brm/Vilanterol Tr | 12 | suppressed |
| Aripiprazole | Aripiprazole | 12 | suppressed |
| Enalapril Maleate | Enalapril Maleate | 12 | suppressed |
| Naproxen | Naproxen | 12 | suppressed |
| Ondansetron Odt | Ondansetron | 12 | suppressed |
| Pravastatin Sodium | Pravastatin Sodium | 12 | suppressed |
| Trulicity | Dulaglutide | 12 | suppressed |
| Fenofibrate | Fenofibrate,micronized | 11 | suppressed |
| Pramipexole Dihydrochloride | Pramipexole Di-Hcl | 11 | suppressed |
| Prazosin Hcl | Prazosin 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 | $58.35 · 3 records | Dexcom, Inc. | Dexcom G6 Transmitter, FARXIGA, QULIPTA, UBRELVY | 1 | — |
| 2024 | — | — | — | — | Complete |
Questions to ask
Questions you could discuss with your doctor
- 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