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: 04/18/2024 · State: TN
Risk Flags
Risk indicators are statistical patterns, not allegations. Learn more
542
Total Claims
$32K
Drug Cost
49
Beneficiaries
$663
Cost/Patient
Risk Score Breakdown 28/100
Score components are additive. Read full methodology
Peer Comparison vs. 106,889 Family Practice providers
-38%
Cost per patient vs peers
$663 vs $1,068 avg
-24%
Brand preference vs peers
6.8% vs 9.0% 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.
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.
Insights generated from CMS data analysis. Statistical patterns are not accusations — always consider clinical context.
Brand vs Generic
Brand: 37 claims · $13K
Generic: 505 claims · $20K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Buprenorphine Hcl/Naloxone Hcl | 70 | $10K |
| Buprenorphine Hcl | 66 | $3,923 |
| Gabapentin | 57 | $1,206 |
| Clonazepam | 82 | $541 |
| Albuterol Sulfate | 24 | $464 |
| Pantoprazole Sodium | 24 | $317 |
| Zolpidem Tartrate | 11 | $105 |
Prescribing Profile
7
Unique Drugs
28.0
Anomaly Score
Patient Profile
60
Avg Age
57%
Female
1.49
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