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: 1128a4 · Date: 04/20/2025 · State: FL
Risk Flags
Risk indicators are statistical patterns, not allegations. Learn more
744
Total Claims
$35K
Drug Cost
60
Beneficiaries
$582
Cost/Patient
Risk Score Breakdown 54/100
Score components are additive. Read full methodology
Peer Comparison vs. 106,889 Family Practice providers
+786%
Opioid rate vs peers
22.8% vs 2.6% avg
-46%
Cost per patient vs peers
$582 vs $1,068 avg
⚠️ This provider has metrics more than 3 standard deviations above their specialty average in one or more categories.
⚠️ Opioid + Benzodiazepine Co-Prescriber
This provider prescribes both opioids and benzodiazepines. The FDA has issued a Black Box Warning about the life-threatening risks of concurrent use.
🔎 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 prescribing rate is 786% above the average for Family Practice providers. While some providers legitimately treat pain-heavy populations, deviations of this magnitude are rare and warrant examination.
This provider co-prescribes opioids and benzodiazepines — a combination carrying an FDA Black Box Warning due to increased risk of respiratory depression and death. While sometimes clinically necessary, this combination requires careful justification.
Composite risk score of 54/100 places this provider in the "High Risk" category — the top 0.017% of all Medicare Part D prescribers. Multiple independent risk factors are contributing simultaneously.
Insights generated from CMS data analysis. Statistical patterns are not accusations — always consider clinical context.
Opioid Prescribing
22.8%
Opioid Rate
170
Opioid Claims
$12K
Opioid Cost
35.9%
Long-Acting Rate
This provider's opioid prescribing rate of 22.8% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 0 claims · $0
Generic: 664 claims · $21K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Hydromorphone Hcl | 53 | $3,733 |
| Morphine Sulfate | 38 | $2,732 |
| Oxycodone Hcl | 43 | $2,592 |
| Cyclobenzaprine Hcl | 28 | $1,959 |
| Alprazolam | 24 | $967 |
| Gabapentin | 72 | $936 |
| Methadone Hcl | 21 | $862 |
| Diclofenac Sodium | 36 | $784 |
| Ibuprofen | 89 | $728 |
| Hydrocodone/Acetaminophen | 13 | $419 |
| Tizanidine Hcl | 11 | $332 |
| Pregabalin | 18 | $318 |
| Lisinopril | 14 | $191 |
| Omeprazole | 23 | $172 |
| Duloxetine Hcl | 17 | $168 |
Prescribing Profile
16
Unique Drugs
54.0
Anomaly Score
Patient Profile
62
Avg Age
52%
Female
1.72
Avg Risk Score
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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