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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 →

Michael GaineyM.D.

Emergency Medicine · Cynthiana, KY 41031

NPI: 1194796169

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49

🟠 Elevated

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

Exclusion type: 1128a4 · Date: 20251120 · State: KY

Risk Flags

High antipsychotic prescribing (65+)Opioid + benzodiazepine co-prescriberOIG Excluded Providerextreme_fills_per_patient

Risk indicators are statistical patterns, not allegations. Learn more

29,481

Total Claims

$2.9M

Drug Cost

895

Beneficiaries

$3,285

Cost/Patient

Risk Score Breakdown 49/100

Low (0)Moderate (15)Elevated (30)High (50+)
OIG excluded provider+20
Elderly antipsychotic prescribing+10
Opioid + benzodiazepine combo+8
High fills per patient+5

Score components are additive. Read full methodology

Peer Comparison vs. 44,021 Emergency Medicine providers

-22%

Opioid rate vs peers

7.3% vs 9.4% avg

+765%

Brand preference vs peers

12.8% vs 1.5% avg

⚠️ This provider has metrics more than 3 standard deviations above their specialty average in one or more categories.

⚠️ 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

7.3%

Opioid Rate

2,155

Opioid Claims

$57K

Opioid Cost

0.8%

Long-Acting Rate

Brand vs Generic

87% generic

Brand: 3,747 claims · $2.3M

Generic: 25,435 claims · $608K

Top Prescribed Drugs

Drug (Generic)ClaimsCost
Deutetrabenazine160$586K
Paliperidone Palmitate58$193K
Semaglutide126$143K
Rivaroxaban287$114K
Fluticasone/Umeclidin/Vilanter133$100K
Aripiprazole33$88K
Apixaban197$85K
Fluticasone/Vilanterol132$60K
Sitagliptin Phosphate88$53K
Empagliflozin105$50K
Insulin Glargine,hum.Rec.Anlog139$47K
Cariprazine Hcl59$45K
Linagliptin110$45K
Linaclotide66$44K
Dupilumab11$42K

Prescribing Profile

242

Unique Drugs

$365K

IRA Negotiated Drugs

$187K

GLP-1 Drugs

49.0

Anomaly Score

Patient Profile

67

Avg Age

58%

Female

1.54

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