Thomas is a 57-year-old male who suffers from pure hypercholesterolemia (E78.0), along with atherosclerosis of native artery of both lower extremities with intermittent claudication, peripheral artery disease, coronary artery disease, hypertension, vitamin D deficiency, and diabetes. Although his primary diagnosis is not foreseen as an approved diagnosis for this medication; he also suffers from other underlying heart conditions in which will deem him medically necessary to receive Repatha. Since starting Repatha, Thomas has tolerated the treatment well and has seen improvement in lipid levels. Thomas has been on Repatha since January of 2017. His most recent lab work reveals total cholesterol is 94, triglycerides 226, HDL 35 and LDL 14.