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: 1128(b)(4) — License Revocation/Suspension · Date: 10/20/2024 · State: CA
Risk Flags
Risk indicators are statistical patterns, not allegations. Learn more
249
Total Claims
$10K
Drug Cost
64
Beneficiaries
$161
Cost/Patient
Risk Score Breakdown 41/100
Score components are additive. Read full methodology
Peer Comparison vs. 7,389 General Practice providers
+679%
Opioid rate vs peers
19.3% vs 2.5% avg
-86%
Cost per patient vs peers
$161 vs $1,128 avg
⚠️ 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 679% above the average for General 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.
Prescribes only 7 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
19.3%
Opioid Rate
48
Opioid Claims
$2,239
Opioid Cost
—
Long-Acting Rate
Brand vs Generic
Brand: 0 claims · $0
Generic: 239 claims · $4,730
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Hydrocodone/Acetaminophen | 24 | $689 |
| Quetiapine Fumarate | 12 | $311 |
| Clonazepam | 19 | $242 |
| Cephalexin | 14 | $236 |
| Cyclobenzaprine Hcl | 11 | $137 |
| Azithromycin | 12 | $59 |
| Furosemide | 12 | $38 |
Prescribing Profile
7
Unique Drugs
41.0
Anomaly Score
Patient Profile
72
Avg Age
61%
Female
0.91
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