Who Are the Highest-Cost Prescribers?
Medicare Part D spent $275.6 billion on prescription drugs in 2023, but spending is heavily concentrated among a relatively small number of providers. The top 1,000 prescribers alone account for a disproportionate share.
The Top 10 by Total Drug Cost
| Provider | Specialty | Drug Cost | Brand % |
|---|---|---|---|
| Armaghan Azad Moreno Valley, CA | Emergency Medicine | $160.3M | 100% |
| Cedric Davis Lauderdale Lakes, FL | Family Practice | $137.1M | 99% |
| John Bogdasarian Fitchburg, MA | Otolaryngology | $68.7M | 100% |
| Ruth Mays Highland Park, MI | Family Practice | $63.2M | 100% |
| Erin Pettijohn Grand Rapids, MI | Hematology-Oncology | $13.5M | — |
| Stephen Anesi Waltham, MA | Ophthalmology | $8.6M | — |
| Joshua Lukenbill Des Moines, IA | Hematology-Oncology | $6.9M | — |
| Tondre Buck Spartanburg, SC | Medical Oncology | $6.8M | — |
| Erica Kretchman Richmond, IN | Endocrinology | $5.5M | 61% |
| Muhammad Popalzai Carterville, IL | Hematology-Oncology | $5.4M | 28% |
What Drives High Costs?
Not all high-cost prescribers are problematic. Several legitimate factors drive costs:
- Specialty drugs — Oncologists and rheumatologists prescribe biologics costing thousands per dose
- Rare disease treatments — Some drugs have no generic alternatives
- High patient volume — Large practices naturally generate more costs
- Brand-name preference — Some providers prescribe brands when generics exist
The last factor is where scrutiny matters most. Providers with both high costs and high brand-name percentages when generics are available may be costing Medicare billions unnecessarily.
Cost Per Patient
Raw cost totals can be misleading — a provider seeing 10,000 patients will naturally spend more than one seeing 100. Cost per beneficiary is a more useful metric. Our top-cost providers range from $22K to $326 per patient.
Explore the data: Brand vs Generic Analysis →