Writing all the prescriptions, investigators say, was Alexander Theodore, who also worked part time as a physician at a juvenile detention facility.
The alleged OxyContin ring included 234 people who recruited other "patients" as well as obtaining and distributing OxyContin.
On Thursday, a federal grand jury rendered an 83-count indictment against Theodore, including ongoing criminal enterprise, crimes against the United States, conspiracy to distribute drugs and drug distribution.
The FBI was expected to hold a news conference about the indictment today.
"It's huge," said Joe Christensen, director of the state Insurance Department's Insurance Fraud Division. "Absolutely huge. . . . The more we looked into it, the more it grew."
The Utah Division of Professional and Occupational Licensing Web site shows Theodore's medical license status as "active on probation."
Theodore worked part time under contract with the University of Utah College of Nursing to provide medical services at the Salt Lake Valley Detention Center, where he treated residents as a physician. Theodore had been there about five years and no longer works there.
The alleged illegal prescription-writing did not take place at the detention facility.
But at Advanced Pain & Weight Management, 1787 E. Fort Union Blvd., Theodore allegedly charged "patients" $400 to $500 for an office visit, the sole purpose of which, confidential informants said, was to obtain OxyContin, according to an affidavit for a search warrant filed in 3rd District Court.
The affidavit described the alleged scheme:
l Recruiters sought "patients" whose insurance covered the powerful pain medication and set up an appointment for them with Theodore.
l The doctor would give them unnecessary prescriptions for OxyContin and charge them for the office visit.
l The recruiters sometimes would pay the office visit fee, and in return, the "patients" had to give the recruiter at least 75 percent of their OxyContin. If the "patients" were able to pay the fee on their own, they could keep the drug.
The "patients" were twenty-somethings from middle-class families whose insurance covered OxyContin - mostly under their parents' health plans.
And when they realized how powerful, but expensive, the drug was, they started recruiting others, Christensen said. They recruited "typical" Utahns - including church-goers and people going on missions.
For some it was a way to make money, but most were feeding their own drug habit and didn't view the prescriptions as insurance fraud.
"It just ballooned into this very complex organization," Christensen said. "It was very well organized."
Individuals in the ring were responsible for different tasks, such as enforcers and distributors sold the drugs on the street.
Eventually, the drug ring cut into traditional heroin sales and crossed a local street gang.
As a result, the gang started to receive a cut of the OxyContin pills, which it sold to its clientele, and provided enforcers in the drug ring, Christensen said.
Enforcers allegedly also included a couple of juvenile detention center employees, who have been terminated from the center. It was unclear how they were recruited.
Enforcers threatened some of the people who tried to back out, Christensen said. In one case, a person received a call at work from an enforcer who threatened to rape his wife.
The drug ring came to the attention of state authorities by pharmacists who noticed younger people were coming in with OxyContin prescriptions and suspected something was going on.
Investigators obtained prescription information from five legitimate pain clinic physicians in Utah from January 2004 to mid-February 2005. Of those, the physician who prescribed the most OxyContin tablets wrote prescriptions for a total of nearly 8,500 40- and 80-milligram tablets.
Theodore prescribed a total of almost 74,000 40- and 80-milligram tablets during the same span, according to court records.
Prosecutors have charged about 56 people in connection with the OxyContin ring.