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Federal Register / Vol. 86, No. 188 / Friday, October 1, 2021 / Notices
On rebuttal, Dr. Hamilton compared versions of the same medical records as to B.N., GX 13 and RX 26, 27. After pointing out differences in the two versions, and granting the reliability of the Respondents versions, Dr. Hamilton opined that considering the RX 26 and 27 version, his previous opinions as to B.N.s dispensing remained the same.
Tr. 98085.
As to patient K.Y.D., Dr. Hamilton identified a series of oxycodone prescriptions with unresolved red flags. Tr. 237; GX16, pp. 12, 56, 9
10, 6364; RX 30, 31, pp. 24. The first three involved a dosage of 30 mg, quantity 84, price $290. Tr. 23739
For these prescriptions, Dr. Hamilton testified that the red flags included the highest strength dosage, high quantity, frequency of prescribed usage 3 times daily, and high price. By the third prescription, it also triggered an additional red flag involving the ongoing unjustified prescribing of oxycodone. Tr. 239. The fourth example for the identical prescription triggered the same unresolved red flags. L Id. at 240.
On rebuttal, Dr. Hamilton evaluated the Respondents sponsored versions of medical records as to K.Y.D., RX 30, 31.
Dr. Hamilton noted references to a discharge date of June 12, 2017. Tr. 990
91. Even granting the reliability of the records, Dr. Hamilton stuck with his original opinions as to K.Y.D.s dispensing. Tr. 99094.
As to Patient K.E.D., Dr. Hamilton determined there were unresolved red flags involved in a series of oxycodone prescriptions. The first was for 20.5 mg, quantity 112, for $430. Tr. 24145; GX
17, GX 18, pp. 12, 34, 56, 4142; RX
28, RX 29, p. 2. For the first, the dosage of 20.5 mg represents a dosage outside common dosage units, and would have been a compounded dosage, a red flag in itself. Tr. 242. Additionally, Dr.
Hamilton noted that the quantity, and price were unresolved red flags for this prescription. Id. The second and third oxycodone prescription noted were for 20 mg, 112 quantity, priced at $430. Tr.
24445. Again, the medication itself represented a red flag, as well as the dosage, quantity and price. Tr. 245. The fourth oxycodone prescription was identical to the second and third, except that the price was $400. Tr. 24546. In addition to the red flags identified with the prior two prescriptions, the fourth prescription triggered the red flag of an extended prescription L Dr. Hamilton also testified that additional prescriptions issued between March 31, 2016, and June 12, 2017, had the same unresolved red flags.
Tr. 241.

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without apparent justification.M Id. at 246.
On rebuttal, Dr. Hamilton compared versions of the same medical records as to K.E.D. See GX 17; RX 28, 29. After pointing out differences in the two versions, and granting the reliability of the Respondents versions, Dr. Hamilton opined that considering the RX 28 and 29 version, his previous opinions as to K.E.D.s dispensing remained the same.
Tr. 98690.
As to Patient R.R., Dr. Hamilton identified a series of oxycodone prescriptions, each which involved unresolved red flags. Tr. 24750; GX
20, pp. 16, 4142; RX 32, p. 1; RX 33, p. 5. The first prescription was of 18 mg, 112 quantity, priced at $250. Tr. 247.
The first red flag is that the dosage has been compounded, without explanation. Id. The high quantity is a red flag, as well as the high price paid. Id. The second and third prescriptions involved 15 mg, quantity of 112, priced at $270. Tr. 248. The fourth prescription is identical to the second and third, except for the price was $260. Tr. 24950. The third and fourth prescriptions had the same unresolved red flags as the earlier prescriptions, and additionally triggered a red flag as extended prescriptions without apparent justification.N Id.
On rebuttal, Dr. Hamilton evaluated the Respondents sponsored versions of medical records as to R.R. See RX 32, 33. Dr. Hamilton noted references to a discharge date of May 2, 2017, yet another prescription fill on May 30, 2017. Tr. 99495. Even granting the reliability of the records, Dr. Hamilton stuck with his original opinions as to R.R.s dispensing. Id. at 99497.
As to Patient R.V., Dr. Hamilton identified a series of oxycodone prescriptions, each which involved unresolved red flags. Tr. 25156; GX
21; GX 22, pp. 2728, 3132, 3435, 78
79; RX 34, p. 1; RX 35. The first prescription was for 20 mg, 112
quantity, priced at $340. Tr. 251; GX 28.
The first red flag was the high dosage.
Tr. 251. The next red flag was the quantity. Id. And the third was the high price paid. Id. Dr. Hamilton testified that there was no evidence on either the
face of the prescription or in the patient record for R.V. that these red flags were resolved. Id. at 25152. The second prescription was identical to the first and had the same unresolved red flags.. Id. at 253. The third was identical to the first two, except that it was priced at $310. Id. The third prescription had the same unresolved red flags as the earlier prescriptions, and had the additional red flag as an extended prescription without apparent justification. Id. The fourth prescription for oxycodone was of 20 mg, quantity 120, priced at $340 and had the same unresolved red flags as the third.O Id.
at 25455.
On rebuttal, Dr. Hamilton compared versions of the same medical records as to R.V. See GX 21 and RX 34, 35. After pointing out differences in the two versions, and granting the reliability of the Respondents versions, Dr. Hamilton opined that considering the RX 34 and 35 version, his previous opinions as to R.V.s dispensing remained the same.
Tr. 9971001.
As to Patient V.W., Dr. Hamilton identified a series of oxycodone prescriptions, each which involved unresolved red flags. Tr. 25660; GX
23, GX 24, pp. 12, 34, 56, 4142; RX
36. The first prescription was for 15 mg, quantity of 84, priced at $300. Tr. 256.
The first red flag was the relatively high dosage. Tr. 256. The next red flag was the quantity. Id. And the third was the high price paid. Id. The second prescription involved 15 mg, quantity 112, priced at $400. Tr. 257. The third prescription was identical to the second, but was priced at $350. Tr. 258. The third prescription had the same unresolved red flags as prior prescriptions based on the dose and quantity and additional unresolved red flags because the prescription was written for four times a day and filled for only three times a day and as an extended prescription without apparent justification. Id. The fourth prescription was identical to the third, except priced at $285. Id. at 259. The fourth prescription shared the red flags arising based on the dose, quantity, price, and length of time for immediate-release medication. P Id. at 25960.

M Dr. Hamilton testified collectively regarding the remaining prescriptions in GX 18 issued between December 21, 2015, and June 7, 2017, and opined that there were similar red flags for all of those prescriptions and that none of those red flags were resolved. Tr. 246.
N Dr. Hamilton testified collectively regarding the remaining prescriptions in GX 20 issued between December 21, 2015, and May 30, 2017, and opined that there were similar red flags for all of those prescriptions and that none of those red flags were resolved. Tr. 250.

O Dr. Hamilton testified collectively regarding the remaining prescriptions in GX 22 issued between January 11, 2016, and June 19, 2017, and opined that there were similar red flags for all of those prescriptions and that none of those red flags were resolved. Tr. 255.
P Dr. Hamilton testified collectively regarding the remaining prescriptions in GX 24 issued between January 25, 2016, and May 21, 2017, and opined that each had the same red flags as the fourth prescription discussed herein and that none of those red flags were resolved. Tr. 260.

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