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: 93%
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
319
Total Claims
$1,596
Drug Cost
80
Beneficiaries
$20
Cost/Patient
Risk Score Breakdown 11/100
Score components are additive. Read full methodology
Peer Comparison vs. 70,845 Dentist providers
+287%
Opioid rate vs peers
21.9% vs 5.7% 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 93% indicates prescribing patterns with significant similarity to confirmed fraud cases. 19 out of 20 decision trees flagged this provider.
Opioid rate is 287% above Dentist 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.
Prescribes only 7 unique drugs, which is unusually low. Most providers prescribe 30+ different medications. Narrow prescribing patterns deserve context about the provider's practice scope.
Insights generated from CMS data analysis. Statistical patterns are not accusations — always consider clinical context.
Opioid Prescribing
21.9%
Opioid Rate
70
Opioid Claims
$135
Opioid Cost
—
Long-Acting Rate
This provider's opioid prescribing rate of 21.9% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 0 claims · $0
Generic: 311 claims · $1,458
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Amoxicillin | 77 | $196 |
| Naproxen | 44 | $161 |
| Amoxicillin/Potassium Clav | 11 | $142 |
| Tramadol Hcl | 68 | $120 |
| Methylprednisolone | 13 | $105 |
| Metronidazole | 14 | $53 |
| Alprazolam | 28 | $21 |
Prescribing Profile
7
Unique Drugs
11.0
Anomaly Score
Patient Profile
76
Avg Age
68%
Female
1.03
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