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: 1128b7 · Date: 10/07/2024 · State: CA
Risk Flags
Risk indicators are statistical patterns, not allegations. Learn more
980
Total Claims
$43K
Drug Cost
106
Beneficiaries
$406
Cost/Patient
Risk Score Breakdown 38/100
Score components are additive. Read full methodology
Peer Comparison vs. 110,156 Internal Medicine providers
+420%
Opioid rate vs peers
11.6% vs 2.2% avg
-71%
Cost per patient vs peers
$406 vs $1,411 avg
-5%
Brand preference vs peers
10.1% vs 10.6% 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 rate is 420% above Internal Medicine peers. This is a significant deviation that may reflect a specialized patient population or concerning prescribing patterns.
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.
Opioid Prescribing
11.6%
Opioid Rate
114
Opioid Claims
$4,156
Opioid Cost
—
Long-Acting Rate
Brand vs Generic
Brand: 98 claims · $21K
Generic: 870 claims · $21K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Aripiprazole | 17 | $3,884 |
| Oxycodone Hcl | 43 | $1,259 |
| Liothyronine Sodium | 27 | $1,198 |
| Levothyroxine Sodium | 79 | $1,147 |
| Bupropion Hcl | 46 | $1,110 |
| Progesterone, Micronized | 19 | $1,102 |
| Albuterol Sulfate | 16 | $950 |
| Oxycodone Hcl/Acetaminophen | 23 | $913 |
| Gabapentin | 40 | $810 |
| Duloxetine Hcl | 30 | $795 |
| Hydrocodone/Acetaminophen | 23 | $605 |
| Trazodone Hcl | 37 | $439 |
| Estradiol | 15 | $342 |
| Celecoxib | 17 | $298 |
| Alprazolam | 36 | $282 |
Prescribing Profile
29
Unique Drugs
38.0
Anomaly Score
Patient Profile
69
Avg Age
79%
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