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
9,170
Total Claims
$938K
Drug Cost
646
Beneficiaries
$1,452
Cost/Patient
Risk Score Breakdown 36/100
Score components are additive. Read full methodology
Peer Comparison vs. 109,535 Physician Assistant providers
+389%
Opioid rate vs peers
45.0% vs 9.2% avg
+102%
Cost per patient vs peers
$1,452 vs $719 avg
+61%
Brand preference vs peers
10.7% vs 6.7% 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 83% indicates prescribing patterns with significant similarity to confirmed fraud cases. 17 out of 20 decision trees flagged this provider.
Opioid rate is 389% above Physician Assistant 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
45.0%
Opioid Rate
4,122
Opioid Claims
$224K
Opioid Cost
17.9%
Long-Acting Rate
This provider's opioid prescribing rate of 45.0% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 984 claims · $583K
Generic: 8,186 claims · $355K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Methylnaltrexone Bromide | 84 | $195K |
| Cyclobenzaprine Hcl | 409 | $56K |
| Lidocaine | 64 | $53K |
| Lidocaine | 384 | $44K |
| Oxycodone Hcl | 100 | $37K |
| Rimegepant Sulfate | 19 | $36K |
| Oxycodone Hcl | 1,408 | $32K |
| Oxycodone Hcl/Acetaminophen | 917 | $31K |
| Pregabalin | 23 | $27K |
| Buprenorphine Hcl | 52 | $26K |
| Naloxegol Oxalate | 51 | $24K |
| Diclofenac Sodium | 257 | $21K |
| Gabapentin Enacarbil | 20 | $19K |
| Milnacipran Hcl | 24 | $18K |
| Buprenorphine Hcl/Naloxone Hcl | 107 | $17K |
Prescribing Profile
60
Unique Drugs
36.0
Anomaly Score
Patient Profile
66
Avg Age
63%
Female
1.73
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