⚠️

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 →

Melissa GainesMD

Internal Medicine · Springfield, MO 65807

NPI: 1376557264

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25

🟡 Moderate

Risk Flags

Elevated long-acting opioid rateHigh antipsychotic prescribing (65+)Opioid + benzodiazepine co-prescriber

Risk indicators are statistical patterns, not allegations. Learn more

22,340

Total Claims

$2.0M

Drug Cost

1,208

Beneficiaries

$1,631

Cost/Patient

Risk Score Breakdown 25/100

Low (0)Moderate (15)Elevated (30)High (50+)
Elderly antipsychotic prescribing+10
Opioid + benzodiazepine combo+8
Long-acting opioid rate+4

Score components are additive. Read full methodology

Peer Comparison vs. 110,156 Internal Medicine providers

+142%

Opioid rate vs peers

5.4% vs 2.2% avg

+16%

Cost per patient vs peers

$1,631 vs $1,411 avg

+30%

Brand preference vs peers

13.8% 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 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

5.4%

Opioid Rate

1,211

Opioid Claims

$55K

Opioid Cost

18.3%

Long-Acting Rate

Brand vs Generic

86% generic

Brand: 3,057 claims · $1.6M

Generic: 19,112 claims · $377K

Top Prescribed Drugs

Drug (Generic)ClaimsCost
Apixaban468$370K
Empagliflozin169$137K
Dulaglutide62$81K
Rivaroxaban88$72K
Semaglutide41$60K
Mirabegron93$56K
Insulin Glargine,hum.Rec.Anlog69$50K
Dapagliflozin Propanediol46$43K
Tiotropium Bromide51$38K
Sitagliptin Phosphate32$36K
Rsvpref3 Antigen/As01e/Pf109$35K
Rsv Vacc, Pref A And Pref B/Pf100$32K
Budesonide/Formoterol Fumarate57$30K
Liraglutide16$28K
Fluticasone/Umeclidin/Vilanter30$28K

Prescribing Profile

207

Unique Drugs

$705K

IRA Negotiated Drugs

$202K

GLP-1 Drugs

25.0

Anomaly Score

Patient Profile

79

Avg Age

78%

Female

1.48

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