Howard Pettigrew, MD
Allergy · Fresno, CANPI 1891961835
Payments from drug & device makers
What this record shows
Almost everything reported here is food and beverage — 95.9% of the total across 167 separate payments, which is the pattern of a clinician who attends manufacturer presentations rather than one with a consulting arrangement. It is spread thinly across 19 manufacturers, the largest accounting for just 17.3% — the pattern of someone who eats at a lot of different presentations. 2025 is the largest year on record at $1,223, 5.3 times the $230 reported in 2019.
Across 167 payments — averaging $18.70 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Biocryst US Sales Co., LLC$539
- GSK$491
- AstraZeneca$320
- CSL Behring$286
- Octapharma USA, Inc.$282
- Novartis$187
- plus $1K from 13 others
What the payments were for
- Food & beverage$2,99496%
- Education$1294%
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 |
|---|---|---|
| Biocryst US Sales Co., LLC | 25 | $539 |
| GSK | 38 | $491 |
| AstraZeneca | 16 | $320 |
| CSL Behring | 19 | $286 |
| Octapharma USA, Inc. | 8 | $282 |
| Novartis | 10 | $187 |
| Amgen | 13 | $165 |
| Takeda Pharmaceuticals U.S.A., Inc. | 7 | $129 |
| Regeneron Healthcare Solutions, Inc. | 4 | $123 |
| ARS Pharmaceuticals Operations, Inc. | 4 | $107 |
| Sanofi-aventis U.S. LLC | 1 | $95 |
| Incyte Corporation | 4 | $85 |
| Sanofi | 4 | $72 |
| Teva Pharmaceuticals USA, Inc. | 4 | $72 |
| Boehringer Ingelheim | 4 | $71 |
| Optinose US, Inc. | 2 | $35 |
| Pfizer | 2 | $31 |
| Paratek Pharmaceuticals, Inc. | 1 | $17 |
| LEO Pharma Inc. | 1 | $16 |
How this compares
$3,123 in reported general payments places this provider in the 55th percentile of 117 allergy providers in California.
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 |
|---|---|---|
| Trelegy ElliptaFluticasone/Umeclidin/Vilanter | 150 | $105,937 |
| Breo ElliptaFluticasone/Vilanterol | 113 | $55,324 |
| Arnuity ElliptaFluticasone Furoate | 49 | $15,715 |
| Advair HfaFluticasone Propion/Salmeterol | 38 | $15,084 |
| Azelastine Hcl | 356 | $11,297 |
| Spiriva RespimatTiotropium Bromide | 16 | $9,396 |
| Fluticasone-Salmeterol HfaFluticasone Propion/Salmeterol | 19 | $7,984 |
| DuleraMometasone/Formoterol | 13 | $7,570 |
| Incruse ElliptaUmeclidinium Bromide | 14 | $7,085 |
| Epinephrine | 40 | $6,666 |
| Ipratropium Bromide | 148 | $6,005 |
| Albuterol Sulfate HfaAlbuterol Sulfate | 183 | $4,225 |
| BreynaBudesonide/Formoterol Fumarate | 25 | $4,148 |
| Fluticasone Propionate | 274 | $3,566 |
| Fluticasone-SalmeterolFluticasone Propion/Salmeterol | 28 | $3,331 |
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 |
|---|---|---|
| GSKTrelegy Ellipta, Breo Ellipta, Arnuity Ellipta, Incruse Ellipta | $491 | $184,061326 claims |
| Boehringer IngelheimSpiriva Respimat | $71 | $9,39616 claims |
| AstraZenecaSymbicort | $320 | $3,10714 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 55th percentile of 117 allergy providers in California.
Other allergy in Fresno
- Angela SabryFresno$33K
- Malik BazFresno$2K
- Joshua JacobsWalnut Creek$1.5M
- Warner CarrLaguna Niguel$571K
- Bradley ChippsSacramento$571K
- Travis MillerRoseville$273K
- Robert ZeigerSan Diego$162K
- William BergerMission Viejo$76K
- Sandra ChristiansenSan Diego$74K
- Stephen WongHacienda Heights$50K
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.