Michelle Langrehr, NP
Nurse Practitioner · Wilmington, DENPI 1427085950
Payments from drug & device makers
Across 9 payments — averaging $20.89 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Exact Sciences$41
- Tactile Systems Technology Inc$37
- Astellas Pharma US Inc$30
- Lilly USA, LLC$28
- Genentech USA, Inc.$22
- Novo Nordisk$17
- plus $14 from 1 others
What the payments were for
- Food & beverage$188100%
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 |
|---|---|---|
| Exact Sciences | 2 | $41 |
| Tactile Systems Technology Inc | 1 | $37 |
| Astellas Pharma US Inc | 2 | $30 |
| Lilly USA, LLC | 1 | $28 |
| Genentech USA, Inc. | 1 | $22 |
| Novo Nordisk | 1 | $17 |
| Kowa Pharmaceuticals America, Inc. | 1 | $14 |
How this compares
$188 in reported general payments places this provider in the 50th percentile of 487 nurse practitioner providers in Delaware.
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 |
|---|---|---|
| Cephalexin | 35 | $1,022 |
| Albuterol Sulfate HfaAlbuterol Sulfate | 31 | $668 |
| Doxycycline Hyclate | 89 | $594 |
| Nitrofurantoin Mono-MacroNitrofurantoin Monohyd/M-Cryst | 38 | $407 |
| ErythromycinErythromycin Base | 24 | $295 |
| Amoxicillin-Clavulanate PotassAmoxicillin/Potassium Clav | 43 | $290 |
| Amoxicillin | 60 | $238 |
| ValacyclovirValacyclovir Hcl | 12 | $237 |
| Prednisone | 80 | $155 |
| Ciprofloxacin Hcl | 13 | $122 |
| Methylprednisolone | 15 | $117 |
| Mupirocin | 13 | $99 |
| Polymyxin B Sul-TrimethoprimPolymyxin B Sulf/Trimethoprim | 11 | $69 |
| Triamcinolone Acetonide | 12 | $46 |
| Sulfamethoxazole-TrimethoprimSulfamethoxazole/Trimethoprim | 17 | $43 |
Paid to pharmacies, not to this prescriber.
Other nurse practitioner in Wilmington
- Colleen DitroWilmington$16K
- Jennifer HubbardWilmington$12K
- Monica SamWilmington$7K
- Brenda NardozziWilmington$7K
- Ellen NeffWilmington$5K
- Tina CubetaWilmington$5K
- Auxilia AkalaWilmington$3K
- Melissa LehrWilmington$3K
- Cathy RamageWilmington$2K
- Meghan McCarterSeaford$170K
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.