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 →Felix Melendez OrtizMD
Neuromusculoskeletal Medicine, Sports Medicine · Carolina, PR 00982
NPI: 1356404909
23
🟡 Moderate
🚫 This provider appears on the OIG List of Excluded Individuals/Entities (LEIE)
Exclusion type: 1128(a)(1) — Felony Conviction · Date: 08/20/2023 · State: PR
Risk Flags
Risk indicators are statistical patterns, not allegations. Learn more
6,582
Total Claims
$409K
Drug Cost
571
Beneficiaries
$716
Cost/Patient
Risk Score Breakdown 23/100
Score components are additive. Read full methodology
Peer Comparison vs. 22 Neuromusculoskeletal Medicine, Sports Medicine providers
+16%
Cost per patient vs peers
$716 vs $617 avg
+47%
Brand preference vs peers
10.7% vs 7.3% avg
🔎 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.
Insights generated from CMS data analysis. Statistical patterns are not accusations — always consider clinical context.
Brand vs Generic
Brand: 699 claims · $304K
Generic: 5,837 claims · $104K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Empagliflozin | 26 | $28K |
| Sitagliptin Phos/Metformin Hcl | 45 | $25K |
| Sitagliptin Phos/Metformin Hcl | 19 | $21K |
| Sitagliptin Phosphate | 22 | $21K |
| Rivaroxaban | 22 | $20K |
| Levothyroxine Sodium | 158 | $17K |
| Insulin Lispro Protamin/Lispro | 22 | $16K |
| Insulin Glargine,hum.Rec.Anlog | 30 | $15K |
| Insulin Glargine,hum.Rec.Anlog | 22 | $13K |
| Insulin Glargine/Lixisenatide | 15 | $13K |
| Insulin Nph Hum/Reg Insulin Hm | 31 | $10K |
| Apixaban | 12 | $9,798 |
| Candesartan/Hydrochlorothiazid | 33 | $8,801 |
| Empaglifloz/Linaglip/Metformin | 12 | $7,274 |
| Piroxicam | 146 | $4,933 |
Prescribing Profile
Patient Profile
77
Avg Age
59%
Female
1.66
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