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: 04/20/2025 · State: HI
Risk Flags
Risk indicators are statistical patterns, not allegations. Learn more
97
Total Claims
$3,981
Drug Cost
17
Beneficiaries
$234
Cost/Patient
Risk Score Breakdown 50/100
Score components are additive. Read full methodology
Peer Comparison vs. 106,889 Family Practice providers
+1459%
Opioid rate vs peers
40.2% vs 2.6% avg
-78%
Cost per patient vs peers
$234 vs $1,068 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 1,459% above the average for Family Practice providers. While some providers legitimately treat pain-heavy populations, deviations of this magnitude are rare and warrant examination.
Composite risk score of 50/100 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
40.2%
Opioid Rate
39
Opioid Claims
$2,276
Opioid Cost
—
Long-Acting Rate
This provider's opioid prescribing rate of 40.2% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 0 claims · $0
Generic: 87 claims · $1,703
Patient Profile
71
Avg Age
—
Female
0.99
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