The highest points possible is 999,950 on NES. More are only possible at SNES release Super Mario All-Stars. It can be, that I am wrong, but i am quite sure, 999,950 is the limit.
I've decided I should make a TAS of this game. Unlike Tetris, Dr. Mario has a definite beginning and end which might possibly make it more suited for a TAS. It's possible to simply start at the highest level, but I think it would be just as interesting, if not more so, to simply start at the first level and continue on up to level 20. Regarding optimization, I've observed the following: - Luck manipulation doesn't work the same way as Tetris. Once the level begins, the pills always come in the exact same order. The only way to manipulate this is before the stage begins (most likely by manipulating the frame the stage starts on.) The types and positions of the virii are very likely manipulated the same way. The virii and pill order might be linked. I'll have to experiment some more to see. - Turning pills actually causes them to move faster. By flipping a pill as it drops, it falls faster. A pill also moves faster side-to-side if you flip it while doing so. - The biggest hazard to speed seems to be the remaining pill bits dropping after a virus is destroyed. Not only do they fall much slower than the pills you manually control, but when you get a chain reaction, it waits for all the remaining bits to land before any additional virii are destroyed. This will have to be minimized above all.
Wow. I remember my MOM getting to like level 30+ on High on this once. It was kinda scary to watch....