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 →ML Fraud Detection Score: 83%
Machine learning model identifies prescribing patterns consistent with confirmed fraud cases. This is a statistical indicator, not an accusation.
Risk Flags
Risk indicators are statistical patterns, not allegations. Learn more
1,004
Total Claims
$179K
Drug Cost
353
Beneficiaries
$507
Cost/Patient
Risk Score Breakdown 8/100
Score components are additive. Read full methodology
Peer Comparison vs. 22,639 Obstetrics & Gynecology providers
+296%
Opioid rate vs peers
5.1% vs 1.3% avg
+35%
Cost per patient vs peers
$507 vs $376 avg
+76%
Brand preference vs peers
21.2% vs 12.1% avg
⚠️ 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.
🔎 Data Overview
ML fraud detection score of 83% indicates prescribing patterns with significant similarity to confirmed fraud cases. 17 out of 20 decision trees flagged this provider.
Opioid rate is 296% above Obstetrics & Gynecology peers. This is a significant deviation that may reflect a specialized patient population or concerning prescribing patterns.
This provider co-prescribes opioids and benzodiazepines — a combination carrying an FDA Black Box Warning due to increased risk of respiratory depression and death. While sometimes clinically necessary, this combination requires careful justification.
Insights generated from CMS data analysis. Statistical patterns are not accusations — always consider clinical context.
Opioid Prescribing
5.1%
Opioid Rate
51
Opioid Claims
$188
Opioid Cost
—
Long-Acting Rate
Brand vs Generic
Brand: 213 claims · $130K
Generic: 791 claims · $49K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Mirabegron | 118 | $90K |
| Estradiol | 337 | $34K |
| Estrogens, Conjugated | 25 | $12K |
| Ospemifene | 21 | $8,189 |
| Estradiol | 43 | $7,977 |
| Nitrofurantoin Monohyd/M-Cryst | 66 | $1,798 |
| Oxybutynin Chloride | 12 | $962 |
| Valacyclovir Hcl | 14 | $575 |
| Gabapentin | 19 | $257 |
| Fluconazole | 22 | $225 |
| Hydrocodone/Acetaminophen | 50 | $178 |
| Sulfamethoxazole/Trimethoprim | 26 | $143 |
| Triamcinolone Acetonide | 24 | $121 |
| Nystatin | 11 | $96 |
| Metronidazole | 12 | $80 |
Prescribing Profile
16
Unique Drugs
8.0
Anomaly Score
Patient Profile
72
Avg Age
100%
Female
1.07
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 of wrongdoing.Methodology · About · Dispute this data