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: 92%
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
8,815
Total Claims
$686K
Drug Cost
523
Beneficiaries
$1,312
Cost/Patient
Risk Score Breakdown 15/100
Score components are additive. Read full methodology
Peer Comparison vs. 106,889 Family Practice providers
+217%
Opioid rate vs peers
8.2% vs 2.6% avg
+23%
Cost per patient vs peers
$1,312 vs $1,068 avg
+19%
Brand preference vs peers
10.7% vs 9.0% 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 92% indicates prescribing patterns with significant similarity to confirmed fraud cases. 18 out of 20 decision trees flagged this provider.
Opioid rate is 217% above Family Practice 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
8.2%
Opioid Rate
721
Opioid Claims
$25K
Opioid Cost
12.5%
Long-Acting Rate
Brand vs Generic
Brand: 935 claims · $473K
Generic: 7,777 claims · $208K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Apixaban | 109 | $85K |
| Empagliflozin | 70 | $65K |
| Dulaglutide | 27 | $40K |
| Semaglutide | 34 | $39K |
| Fluticasone Propion/Salmeterol | 40 | $21K |
| Insulin Glargine,hum.Rec.Anlog | 34 | $20K |
| Budesonide/Formoterol Fumarate | 42 | $18K |
| Sitagliptin Phosphate | 23 | $18K |
| Atorvastatin Calcium | 540 | $12K |
| Fluticasone Propionate | 40 | $11K |
| Oxycodone Hcl | 240 | $11K |
| Buprenorphine Hcl/Naloxone Hcl | 65 | $9,928 |
| Ipratropium/Albuterol Sulfate | 19 | $9,862 |
| Dexlansoprazole | 15 | $8,061 |
| Insulin Aspart | 14 | $7,510 |
Prescribing Profile
Patient Profile
70
Avg Age
37%
Female
1.14
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