⚠️

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 →

Bernie SimonsM.D.

Family Practice · Pittsburgh, PA 15216

NPI: 1174548499

Share:𝕏fin

35

🟠 Elevated

🚫 This provider appears on the OIG List of Excluded Individuals/Entities (LEIE)

Exclusion type: 1128b3 · Date: 20240820 · State: PA

Risk Flags

Elevated antipsychotic prescribing (65+)Opioid + benzodiazepine co-prescriberOIG Excluded Provider

Risk indicators are statistical patterns, not allegations. Learn more

4,837

Total Claims

$592K

Drug Cost

412

Beneficiaries

$1,437

Cost/Patient

Risk Score Breakdown 35/100

Low (0)Moderate (15)Elevated (30)High (50+)
OIG excluded provider+20
Opioid + benzodiazepine combo+8
Elderly antipsychotic prescribing+5

Score components are additive. Read full methodology

Peer Comparison vs. 106,889 Family Practice providers

-88%

Opioid rate vs peers

0.3% vs 2.6% avg

+35%

Cost per patient vs peers

$1,437 vs $1,068 avg

+78%

Brand preference vs peers

16.0% 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

0.3%

Opioid Rate

15

Opioid Claims

$114

Opioid Cost

Long-Acting Rate

Brand vs Generic

84% generic

Brand: 772 claims · $493K

Generic: 4,050 claims · $99K

Top Prescribed Drugs

Drug (Generic)ClaimsCost
Apixaban80$69K
Dapagliflozin Propanediol89$64K
Empagliflozin64$56K
Semaglutide43$42K
Rivaroxaban33$30K
Dulaglutide19$29K
Fluticasone/Umeclidin/Vilanter17$23K
Linaclotide23$15K
Mirabegron14$14K
Linagliptin20$13K
Evolocumab20$11K
Erenumab-Aooe12$9,356
Fluticasone/Vilanterol18$8,038
Empagliflozin/Metformin Hcl11$6,708
Mesalamine14$6,235

Prescribing Profile

100

Unique Drugs

$219K

IRA Negotiated Drugs

$71K

GLP-1 Drugs

35.0

Anomaly Score

Patient Profile

72

Avg Age

54%

Female

1.40

Avg Risk Score

Explore More

Data from CMS Medicare Part D Prescriber Public Use File, 2023. Risk scores are statistical indicators, not allegations.Methodology · About