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: 06/19/2025 · State: KY
Risk Flags
Risk indicators are statistical patterns, not allegations. Learn more
23,514
Total Claims
$2.1M
Drug Cost
1,251
Beneficiaries
$1,663
Cost/Patient
Risk Score Breakdown 55/100
Score components are additive. Read full methodology
Peer Comparison vs. 2,621 Pain Management providers
+27%
Opioid rate vs peers
52.5% vs 41.3% avg
+317%
Cost per patient vs peers
$1,663 vs $399 avg
+56%
Brand preference vs peers
5.8% vs 3.8% 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.
Composite risk score of 55/100 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
52.5%
Opioid Rate
12,342
Opioid Claims
$1.5M
Opioid Cost
22.3%
Long-Acting Rate
This provider's opioid prescribing rate of 52.5% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 1,374 claims · $1.3M
Generic: 22,140 claims · $756K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Oxycodone Hcl | 457 | $515K |
| Oxycodone Myristate | 248 | $345K |
| Oxycodone Hcl/Acetaminophen | 3,296 | $163K |
| Hydrocodone/Acetaminophen | 3,525 | $124K |
| Methylnaltrexone Bromide | 39 | $120K |
| Oxycodone Hcl | 2,242 | $87K |
| Buprenorphine Hcl | 58 | $50K |
| Fentanyl | 332 | $45K |
| Gabapentin | 2,154 | $41K |
| Linaclotide | 51 | $39K |
| Rimegepant Sulfate | 29 | $38K |
| Pregabalin | 606 | $38K |
| Morphine Sulfate | 995 | $35K |
| Oxymorphone Hcl | 41 | $32K |
| Naloxegol Oxalate | 48 | $27K |
Prescribing Profile
78
Unique Drugs
55.0
Anomaly Score
Patient Profile
67
Avg Age
60%
Female
1.53
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