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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 →

Terry SimmonsMD

Family Practice · Basehor, KS 66007

NPI: 1053356055

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18

🟡 Moderate

🤖 ML Fraud Detection Score: 86%

Machine learning model identifies prescribing patterns consistent with confirmed fraud cases. This is a statistical indicator, not an accusation.

Learn more →

Risk Flags

Elevated antipsychotic prescribing (65+)Opioid + benzodiazepine co-prescriberHigh fills per patient

Risk indicators are statistical patterns, not allegations. Learn more

12,263

Total Claims

$957K

Drug Cost

623

Beneficiaries

$1,536

Cost/Patient

Risk Score Breakdown 18/100

Low (0)Moderate (15)Elevated (30)High (50+)
Opioid + benzodiazepine combo+8
Elderly antipsychotic prescribing+5
High fills per patient+3

Score components are additive. Read full methodology

Peer Comparison vs. 106,889 Family Practice providers

+129%

Opioid rate vs peers

5.9% vs 2.6% avg

+44%

Cost per patient vs peers

$1,536 vs $1,068 avg

+18%

Brand preference vs peers

10.6% vs 9.0% 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.

Opioid Prescribing

5.9%

Opioid Rate

725

Opioid Claims

$21K

Opioid Cost

9.7%

Long-Acting Rate

Brand vs Generic

89% generic

Brand: 1,288 claims · $732K

Generic: 10,864 claims · $217K

Top Prescribed Drugs

Drug (Generic)ClaimsCost
Apixaban89$82K
Sitagliptin Phosphate64$69K
Insulin Glargine,hum.Rec.Anlog75$66K
Empagliflozin53$58K
Dulaglutide43$53K
Semaglutide42$44K
Rivaroxaban52$40K
Budesonide/Formoterol Fumarate64$35K
Dapagliflozin Propanediol23$28K
Insulin Glargine,hum.Rec.Anlog18$24K
Tirzepatide19$22K
Sitagliptin Phos/Metformin Hcl19$21K
Mirabegron19$17K
Insulin Degludec21$11K
Exenatide Microspheres13$11K

Prescribing Profile

148

Unique Drugs

$277K

IRA Negotiated Drugs

$119K

GLP-1 Drugs

18.0

Anomaly Score

Patient Profile

71

Avg Age

50%

Female

1.13

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.Methodology · About