Risk scores are statistical indicators based on prescribing patterns compared to specialty peers. They are NOT allegations of fraud, misconduct, or improper care. Many legitimate medical reasons can explain outlier prescribing.
Read our methodology →🚫 This provider appears on the OIG List of Excluded Individuals/Entities (LEIE)
Exclusion type: 1128a2 · Date: 09/19/2024 · State: ME
Risk Flags
Risk indicators are statistical patterns, not allegations. Learn more
84
Total Claims
$2,335
Drug Cost
40
Beneficiaries
$58
Cost/Patient
Risk Score Breakdown 20/100
Score components are additive. Read full methodology
Peer Comparison vs. 8,957 Otolaryngology providers
+256%
Opioid rate vs peers
19.0% vs 5.3% avg
-56%
Cost per patient vs peers
$58 vs $132 avg
🔎 Data Overview
This provider appears on the federal OIG exclusion list, meaning they have been formally barred from participating in federal healthcare programs due to fraud, patient abuse, licensing issues, or other misconduct. The fact that they still appear in active prescribing data is a significant concern.
Opioid rate is 256% above Otolaryngology peers. This is a significant deviation that may reflect a specialized patient population or concerning prescribing patterns.
Prescribes only 1 unique drugs, which is unusually low. Most providers prescribe 30+ different medications. Narrow prescribing patterns deserve context about the provider's practice scope.
Insights generated from CMS data analysis. Statistical patterns are not accusations — always consider clinical context.
Opioid Prescribing
19.0%
Opioid Rate
16
Opioid Claims
$234
Opioid Cost
—
Long-Acting Rate
Brand vs Generic
Brand: 0 claims · $0
Generic: 84 claims · $2,335
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Fluticasone Propionate | 14 | $225 |
Prescribing Profile
1
Unique Drugs
20.0
Anomaly Score
Patient Profile
68
Avg Age
55%
Female
1.29
Avg Risk Score
Explore More
Data from CMS Medicare Part D Prescriber Public Use File, 2023. Risk scores are statistical indicators, not allegations of wrongdoing.Methodology · About · Dispute this data