50 Doctors in RI with the Most Medicare Prescription Claims
GoLocalProv News Team and Kate Nagle
50 Doctors in RI with the Most Medicare Prescription Claims
In Rhode Island, the top five prescribing doctors had over 230,000 Medicare Part D claims filled during that time frame, for drugs having a total retail price tag of over $11 million, according to data compiled by ProPublica.
"Yes, there is all of this information available online now, but what you don't see in these numbers is what kind of patients are being treated, and what is the severity of their ailments," said Steve DeToy, Director of Government and Public Affairs with the Rhode Island Medical Society. "So while this data has to be reported - and released -- it needs be viewed in the appropriate context. You need to look closely at the doctors' patient mix."
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GoLocalProv reviewed data collected by non-profit media watchdog ProPublica, who has been collecting and organizing federal data from new federal reporting requirements impacting the Centers for Medicaid and Medicare (CMS).
"The number of prescriptions is just one of many data points that should be reviewed, again, in the appropriate context," said DeToy. "We had a data dump a while back as to who billed Medicare. As it turned out, 80% was a pass through of what [the doctors] had already spent. So Oncology, for instance -- they put out a lot, and then get reimbursed. It can look like these doctors are making millions, and they're not."
Top RI Prescribers -- and Drugs
Huang averaged of 54 prescriptions (including refills) per patient, compared to the state average of 21 for internal medicine.
Dr. Michael Klufas, a geriatric medicine specialist in Cumberland, had 46,702 Medicare Part D prescription claims filled, including refills, for an average of 43 prescriptions per patient; Dr. Shahzad Khurshid, an internal medicine specialist in Cranston, was third highest statewide with 38,060 prescription claims.
Statewide, the top drugs prescribed under Medicare Part D in 2013 were Lisinopril, which treats high blood pressure (211,554 claims); Omerprazole, which treats heartburn and stomach ulcers (190,686 claims); and Amlodipine Besylate, which treats high blood pressure and chest pain (181,903 claims).
The highest costing drugs prescribed? The well-advertised Advair, Spiriva, Abilify, Cymbalta, and Crestor were the top five, with just under 150,000 claims costing $46,261,480.
ProPublica Prescription Concerns
In his report, "One Nation, Under Sedation: Medicare Paid for Nearly 40 Million Tranquilizer Prescriptions in 2013", ProPublica's Charles Ornstein wrote, "A worrisome aspect of the newly released data is that some doctors appear to be prescribing benzodiazepines and narcotic painkillers to the same patients, increasing the risk of misuse and overdose. The drugs, paired together, can depress breathing."
"Congress wouldn’t allow Medicare to pay for benzodiazepines such as Xanax and Ativan until 2013," wrote Ornstein. "Now, the medications are among the most prescribed in its drug program."
In Rhode Island, these benzodiazepines prescriptions ranked this way:
Clonazepam (Klonopin) - 56,601 claims (Total cost of $418,358)
Alprazolam (Xanax) - 47,306 claims filled ($319,799)
Lorazepam (Ativan) - 47,013 claims filled ($396,801)
Diazepam (Valium) - 18,938 claims filled ($153,712)
Temazepam (Restoril) - 8,297 claims filled ($130,574)
According to HealthGrove, at $1.01 Billion, Rhode Island is ranked seventh in America for its total Medicare costs. This cost is distributed among 107,390 Medicare beneficiaries which amounts to $9,409 per person. Controlling for differences in payment rates for individual services across the country, standardized costs are $8,376 per person. Further adjusting for risk, Medicare in Rhode Island typically costs the government $8,662 per person, 8.0% lower than the national average.
Rhode Island - Featured Visualization | HealthGrove
#50 to #1: Doctors in RI with the Most Medicare Prescription Claims
#50
Prescriber: Robert Cicchelli MD
City: Middletown
Claims Filled: 12,483
Total Cost: $548K
# of Medicare D Patients: 480
Claims for Brand Name Drugs: 23%
#49
Prescriber: Parul Shah MD
City: East Providence
Claims Filled: 12,498
Total Cost: $547K
# of Medicare D Patients: 499
Claims for Brand Name Drugs: 19%
#48
Prescriber: Amber Gul M.D.
City: Pawtucket
Claims Filled: 12,694
Total Cost: $524K
# of Medicare D Patients: 463
Claims for Brand Name Drugs: 22%
#47
Prescriber: Mechery Davis MD
City: Warwick
Claims Filled: 13,052
Total Cost: $534K
# of Medicare D Patients: 443
Claims for Brand Name Drugs: 15%
#46
Prescriber: Cassandra Constantino MD
City: Bristol
Claims Filled: 13,054
Total Cost: $493K
# of Medicare D Patients: 530
Claims for Brand Name Drugs: 14%
#45
Prescriber: Joan Harrison M.D.
City: Tiverton
Claims Filled: 13,219
Total Cost: $541K
# of Medicare D Patients: 465
Claims for Brand Name Drugs: 16%
#44
Prescriber: Alberto Erfe MD
City: Woonsocket
Claims Filled: 13,269
Total Cost: $748K
# of Medicare D Patients: 286
Claims for Brand Name Drugs: 28%
#43
Prescriber: Richard Ryter MD
City: Smithfield
Claims Filled: 13,350
Total Cost: $490K
# of Medicare D Patients: 611
Claims for Brand Name Drugs: 15%
#42
Prescriber: Stephen Beaupre MD
City: Cranston
Claims Filled: 13,397
Total Cost: $559K
# of Medicare D Patients: 421
Claims for Brand Name Drugs: 15%
#41
Prescriber: Peter Eller M.D.
City: Pawtucket
Claims Filled: 13,465
Total Cost: $596K
# of Medicare D Patients: 709
Claims for Brand Name Drugs: 15%
#40
Prescriber: Jason Boudjouk M.D.
City: Warwick
Claims Filled: 13,488
Total Cost: $616K
# of Medicare D Patients: 419
Claims for Brand Name Drugs: 20%
#39
Prescriber: Stephanie Krusz MD
City: Cranston
Claims Filled: 13,525
Total Cost: $508K
# of Medicare D Patients: 514
Claims for Brand Name Drugs: 19%
#38
Prescriber: Gilbert Teixeira DO
City: East Providence
Claims Filled: 13,654
Total Cost: $664K
# of Medicare D Patients: 530
Claims for Brand Name Drugs: 17%
#37
Prescriber: Richard Leach DO
City: East Greenwich
Claims Filled: 13,655
Total Cost: $494K
# of Medicare D Patients: 541
Claims for Brand Name Drugs: 17%
#36
Prescriber: James Cardi M.D.
City: Cranston
Claims Filled: 14,253
Total Cost: $554K
# of Medicare D Patients: 621
Claims for Brand Name Drugs: 16%
#35
Prescriber: Leonard Mannarelli D.O.
City: Cranston
Claims Filled: 14,515
Total Cost: $682K
# of Medicare D Patients: 423
Claims for Brand Name Drugs: 19%
#34
Prescriber: John Bandola M.D.
City: Wakefield
Claims Filled: 14,736
Total Cost: $583K
# of Medicare D Patients: 537
Claims for Brand Name Drugs: 18%
#33
Prescriber: Jeffry Winters MD
City: Cranston
Claims Filled: 15,013
Total Cost: $535K
# of Medicare D Patients: 684
Claims for Brand Name Drugs: 15%
#32
Prescriber: Amir Alizadeh, MD Inc. MD
City: North Providence
Claims Filled: 15,019
Total Cost: $506K
# of Medicare D Patients: 683
Claims for Brand Name Drugs: 15%
#31
Prescriber: Herman Ayvazyan MD
City: East Providence
Claims Filled: 15,075
Total Cost: $670K
# of Medicare D Patients: 580
Claims for Brand Name Drugs: 19%
#30
Prescriber: Fred Ferri MD
City: Johnston
Claims Filled: 15,147
Total Cost: $446K
# of Medicare D Patients: 596
Claims for Brand Name Drugs: 13%
#29
Prescriber: Angelo Dicenso M.D.
City: Johnston
Claims Filled: 15,324
Total Cost: $482K
# of Medicare D Patients: 659
Claims for Brand Name Drugs: 15%
#28
Prescriber: Kimberly Humulock DO
City: Warwick
Claims Filled: 15,337
Total Cost: $614K
# of Medicare D Patients: 492
Claims for Brand Name Drugs: 17%
#27
Prescriber: Greigstone Yearwood M.D.
City: Woonsocket
Claims Filled: 15,401
Total Cost: $754K
# of Medicare D Patients: 540
Claims for Brand Name Drugs: 18%
#26
Prescriber: Donald McNiece MD
City: Wakefield
Claims Filled: 15,571
Total Cost: $657K
# of Medicare D Patients: 706
Claims for Brand Name Drugs: 19%
#25
Prescriber: Jeffrey Drogin MD
City: East Providence
Claims Filled: 15,686
Total Cost: $936K
# of Medicare D Patients: 711
Claims for Brand Name Drugs: 22%
#24
Prescriber: David DiCecco M.D.
City: North Providence
Claims Filled: 15,690
Total Cost: $627K
# of Medicare D Patients: 418
Claims for Brand Name Drugs: 23%
#23
Prescriber: Dennis Botelho MD
City: Cranston
Claims Filled: 15,845
Total Cost: $633K
# of Medicare D Patients: 584
Claims for Brand Name Drugs: 17%
#22
Prescriber: Bassam Khabbaz MD
City: Cumberland
Claims Filled: 15,884
Total Cost: $861K
# of Medicare D Patients: 310
Claims for Brand Name Drugs: 26%
#21
Prescriber: Sumaira Ali M.D.
City: Greenville
Claims Filled: 16,266
Total Cost: $761K
# of Medicare D Patients: 446
Claims for Brand Name Drugs: 25%
#20
Prescriber: Gregory Allen D.O.
City: Cranston
Claims Filled: 16,475
Total Cost: $862K
# of Medicare D Patients: 435
Claims for Brand Name Drugs: 26%
#19
Prescriber: Hugo Yamada MD
City: Lincoln
Claims Filled: 16,605
Total Cost: $967K
# of Medicare D Patients: 594
Claims for Brand Name Drugs: 21%
#18
Prescriber: Nicholas Turilli D.O.
City: Warwick
Claims Filled: 16,871
Total Cost: $867K
# of Medicare D Patients: 659
Claims for Brand Name Drugs: 23%
#17
Prescriber: Pamela Harrop MD
City: Bristol
Claims Filled: 17,393
Total Cost: $667K
# of Medicare D Patients: 485
Claims for Brand Name Drugs: 18%
#16
Prescriber: Kathleen Gordon DO
City: Johnston
Claims Filled: 17,864
Total Cost: $734K
# of Medicare D Patients: 626
Claims for Brand Name Drugs: 21%
#15
Prescriber: Job Sandoval MD
City: Westerly
Claims Filled: 18,348
Total Cost: $567K
# of Medicare D Patients: 744
Claims for Brand Name Drugs: 14%
#14
Prescriber: Howard Perrone M.D.
City: Bristol
Claims Filled: 18,585
Total Cost: $746K
# of Medicare D Patients: 531
Claims for Brand Name Drugs: 21%
#13
Prescriber: Stanley Balon M.D.
City: Cumberland
Claims Filled: 19,272
Total Cost: $663K
# of Medicare D Patients: 664
Claims for Brand Name Drugs: 15%
#12
Prescriber: Olga Tverskaya M.D.
City: Cranston
Claims Filled: 19,766
Total Cost: $928K
# of Medicare D Patients: 530
Claims for Brand Name Drugs: 23%
#11
Prescriber: Christopher Superczynski M.D.
City: Woonsocket
Claims Filled: 20,483
Total Cost: $901K
# of Medicare D Patients: 1,008
Claims for Brand Name Drugs: 16%
#10
Prescriber: Edward Gauthier M.D.
City: North Providence
Claims Filled: 20,741
Total Cost: $961K
# of Medicare D Patients: 384
Claims for Brand Name Drugs: 27%
#9
Prescriber: William Beliveau MD
City: Johnston
Claims Filled: 20,888
Total Cost: $952K
# of Medicare D Patients: 931
Claims for Brand Name Drugs: 25%
#8
Prescriber: Frank Maggiacomo D.O.
City: Cranston
Claims Filled: 22,043
Total Cost: $1.01M
# of Medicare D Patients: 869
Claims for Brand Name Drugs: 19%
#7
Prescriber: Ahmad Al-Raqqad M.D.
City: Pawtucket
Claims Filled: 23,773
Total Cost: $1.03M
# of Medicare D Patients: 581
Claims for Brand Name Drugs: 21%
#6
Prescriber: Anthony Lombardi MD
City: Cranston
Claims Filled: 24,203
Total Cost: $1.11M
# of Medicare D Patients: 713
Claims for Brand Name Drugs: 24%
#5
Prescriber: Ralph Santoro M.D.
City: Cranston
Claims Filled: 28,596
Total Cost: $1.32M
# of Medicare D Patients: 641
Claims for Brand Name Drugs: 24%
#4
Prescriber: Avanish Mehta M.D.
City: Cumberland
Claims Filled: 30,098
Total Cost: $1.48M
# of Medicare D Patients: 480
Claims for Brand Name Drugs: 26%
#3
Prescriber: Richard Ruggieri M.D.
City: Providence
Claims Filled: 37,529
Total Cost: $1.82M
# of Medicare D Patients: 1,167
Claims for Brand Name Drugs: 23%
#2
Prescriber: Shahzad Khurshid M.D.
City: Cranston
Claims Filled: 38,060
Total Cost: $1.74M
# of Medicare D Patients: 731
Claims for Brand Name Drugs: 26%
#1
Prescriber: Hao Huang M.D.
City: Cranston
Claims Filled: 83,917
Total Cost: $4.03M
# of Medicare D Patients: 1,568
Claims for Brand Name Drugs: 26%
