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: 98%
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
362
Total Claims
$1,974
Drug Cost
130
Beneficiaries
$15
Cost/Patient
Risk Score Breakdown 11/100
Score components are additive. Read full methodology
Peer Comparison vs. 70,845 Dentist providers
+304%
Opioid rate vs peers
22.9% 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
Our machine learning model — trained on 281 confirmed fraud cases — gives this provider a "Very High" fraud-pattern score. All 20 decision trees in our ensemble model agree that this provider's prescribing patterns resemble those of confirmed fraud cases. This is a statistical finding, not an accusation.
Opioid rate is 304% 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 6 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
22.9%
Opioid Rate
83
Opioid Claims
$208
Opioid Cost
—
Long-Acting Rate
This provider's opioid prescribing rate of 22.9% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 0 claims · $0
Generic: 352 claims · $1,792
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Naproxen | 79 | $431 |
| Amoxicillin | 114 | $396 |
| Methylprednisolone | 18 | $191 |
| Tramadol Hcl | 76 | $172 |
| Azithromycin | 21 | $95 |
| Triazolam | 23 | $45 |
Prescribing Profile
6
Unique Drugs
11.0
Anomaly Score
Patient Profile
73
Avg Age
64%
Female
0.77
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