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: 10/20/2025 · State: KY
Risk Flags
Risk indicators are statistical patterns, not allegations. Learn more
161
Total Claims
$5,430
Drug Cost
29
Beneficiaries
$187
Cost/Patient
Risk Score Breakdown 54/100
Score components are additive. Read full methodology
Peer Comparison vs. 110,156 Internal Medicine providers
+1593%
Opioid rate vs peers
37.9% vs 2.2% avg
-87%
Cost per patient vs peers
$187 vs $1,411 avg
⚠️ This provider has metrics more than 3 standard deviations above their specialty average in one or more categories.
🔎 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 1,593% above the average for Internal Medicine providers. While some providers legitimately treat pain-heavy populations, deviations of this magnitude are rare and warrant examination.
Prescribes only 2 unique drugs with a 37.9% opioid rate. Very low drug diversity combined with high opioid prescribing is a classic statistical marker of potential pill mill operations. However, some legitimate practices (e.g., addiction treatment with buprenorphine) can show similar patterns.
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
37.9%
Opioid Rate
61
Opioid Claims
$2,121
Opioid Cost
—
Long-Acting Rate
This provider's opioid prescribing rate of 37.9% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 0 claims · $0
Generic: 156 claims · $3,410
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Oxycodone Hcl | 55 | $1,973 |
| Cyclobenzaprine Hcl | 30 | $158 |
Prescribing Profile
2
Unique Drugs
54.0
Anomaly Score
Patient Profile
61
Avg Age
55%
Female
2.18
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