David Howard
Endocrinology, Diabetes & Metabolism · Reno, NVNPI 1457557076
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 98.0% of the total across 76 separate payments, which is the pattern of a clinician who attends manufacturer presentations rather than one with a consulting arrangement. 26 manufacturers reported payments, led by Amgen at 24.2% of the total. Reporting peaked in 2023 at $1,394 and has fallen 93.4% since, to $92 in 2025. That places this record below the midpoint for endocrinology, diabetes & metabolism clinicians in NV, where the typical reported total is $4,060.
Across 76 payments — averaging $30.36 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Amgen$559
- AstraZeneca$323
- Dexcom, Inc.$229
- Bayer$143
- Insulet Corporation$117
- Xeris Pharmaceuticals, Inc.$112
- plus $823 from 20 others
Across 2 payments — averaging $6654.98 each. Payments tied to a research study. These frequently flow through the physician to a hospital or research institution rather than to the physician personally.
- Eli Lilly$13K
- Corcept Therapeutics$156
What the payments were for
- Food & beverage$2,26198%
- Education$472%
Most of this is food and beverage — typically meals provided during product presentations at a clinic or hospital. Nationally that is the single largest category of reported payments by count.
General payments by program year
Who reported the general payments
Companies are grouped under their corporate parent — a single manufacturer often files under several CMS reporting entities. Research and ownership payments are counted separately and are not in this table.
| Company | Payments | Total |
|---|---|---|
| Amgen(2 entities) | 15 | $559 |
| AstraZeneca(2 entities) | 10 | $323 |
| Dexcom, Inc. | 6 | $229 |
| Bayer | 6 | $143 |
| Insulet Corporation | 5 | $117 |
| Xeris Pharmaceuticals, Inc. | 1 | $112 |
| Ascendis Pharma Endocrinology Inc | 1 | $105 |
| Renalytix AI, Inc. | 1 | $83 |
| Sanofi-aventis U.S. LLC | 4 | $78 |
| Takeda Pharmaceuticals U.S.A., Inc. | 3 | $62 |
| GSK | 3 | $60 |
| Recordati_rare_diseases_inc. | 2 | $50 |
| Otsuka America Pharmaceutical, Inc. | 2 | $45 |
| Mallinckrodt Hospital Products Inc. | 2 | $45 |
| Travere Therapeutics, Inc. | 3 | $39 |
| Fresenius USA Marketing, Inc. | 2 | $34 |
| Novo Nordisk | 1 | $32 |
| Rhythm Pharmaceuticals, Inc. | 1 | $26 |
| Abbott | 1 | $25 |
| Inspire Medical Systems, Inc. | 1 | $25 |
| Ardelyx, Inc. | 1 | $24 |
| Regeneron Healthcare Solutions, Inc. | 1 | $23 |
| Daiichi Sankyo Inc. | 1 | $19 |
| Chiesi USA, Inc. | 1 | $18 |
| Averitas Pharma Inc. | 1 | $15 |
| Radius Health, Inc. | 1 | $15 |
What the payments were tied to
Products named in the reported payments. Only payments of $100 or more are attributed here — the typical reported payment nationally is a meal worth about $16, and listing those product-by-product would be noise.
- DEXCOM G7 GSS (161)$125
- Tavneos$123
- TEPEZZA$114
- RECORLEV$112
How this compares
$2,307 in reported general payments places this provider in the 40th percentile of 75 endocrinology, diabetes & metabolism providers in Nevada.
See all endocrinology, diabetes & metabolism providers in Nevada →
Medicare billing
What this is not: this is the amount Original Medicare Part B allowed for services this provider billed in 2024. It is not their income. It excludes Medicare Advantage — now more than half of all Medicare enrollment — along with Medicaid and all commercial insurance, and it is gross practice revenue before staff, rent, supplies and malpractice premiums. CMS also suppresses any figure covering ten or fewer patients, so low-volume providers appear smaller than they are.
Most prescribed under Part D
| Drug | Claims | Cost to plans & patients |
|---|---|---|
| OzempicSemaglutide | 66 | $104,869 |
| TrulicityDulaglutide | 54 | $96,000 |
| MounjaroTirzepatide | 44 | $55,206 |
| ForteoTeriparatide | 12 | $49,881 |
| JardianceEmpagliflozin | 46 | $44,905 |
| RybelsusSemaglutide | 19 | $35,779 |
| Tresiba Flextouch U-200Insulin Degludec | 14 | $26,037 |
| FarxigaDapagliflozin Propanediol | 21 | $23,274 |
| Tresiba Flextouch U-100Insulin Degludec | 18 | $13,371 |
| Soliqua 100-33Insulin Glargine/Lixisenatide | 20 | $12,385 |
| Novolog FlexpenInsulin Aspart | 25 | $6,908 |
| Lantus SolostarInsulin Glargine,hum.Rec.Anlog | 35 | $6,036 |
| SynthroidLevothyroxine Sodium | 30 | $3,129 |
| Levothyroxine Sodium | 180 | $2,526 |
| Nano 2nd Gen Pen NeedlePen Needle, Diabetic | 23 | $2,177 |
Paid to pharmacies, not to this prescriber.
Companies that both paid and supply prescribed drugs
These companies both reported payments to this provider and make drugs the provider prescribed under Medicare Part D in 2024. For most specialties this overlap is expected — a cardiologist who is paid by a cardiology drugmaker also treats heart disease. It is shown so the reader can see it, not because it implies anything on its own.
| Company | Paid to this provider | Part D cost of their drugs |
|---|---|---|
| Novo NordiskOzempic, Rybelsus | $32 | $140,64885 claims |
| AstraZenecaFarxiga | $323 | $23,27421 claims |
| Sanofi-aventis U.S. LLCSoliqua 100-33 | $78 | $12,38520 claims |
Reading this fairly. The Part D column is what drug plans and patients paid pharmacies — this provider received none of it, and it reflects how many patients they treat and what those drugs cost. Against peers, this provider's reported payments sit in the 40th percentile of 75 endocrinology, diabetes & metabolism providers in Nevada.
Other endocrinology, diabetes & metabolism in Reno
- Nitesh KuhadiyaReno$595K
- Lisa AbbottReno$130K
- Michael Raymund GonzalesReno$90K
- Claude LardinoisReno$65K
- Sarah MoatsReno$23K
- Daniel CarusoReno$12K
- Robert FredericksReno$10K
- Polina ZykovaReno$7K
- James AtchesonReno$2K
- Fadi HendeeReno$2K
Where these figures come from
- Payments: CMS Open Payments, program years 2019–2025 (publication P06302026_06032026).
- Billing: Medicare Physician & Other Practitioners, data year 2024. Original Medicare Part B only.
- Identity: NPPES NPI Registry, July 2026.