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: 90%
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
10,782
Total Claims
$1.7M
Drug Cost
722
Beneficiaries
$2,365
Cost/Patient
Risk Score Breakdown 21/100
Score components are additive. Read full methodology
Peer Comparison vs. 21,141 Psychiatry providers
+39%
Cost per patient vs peers
$2,365 vs $1,696 avg
+43%
Brand preference vs peers
7.1% vs 5.0% 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 90% indicates prescribing patterns with significant similarity to confirmed fraud cases. 18 out of 20 decision trees flagged this provider.
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.
Brand vs Generic
Brand: 759 claims · $1.4M
Generic: 10,001 claims · $328K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Paliperidone Palmitate | 170 | $486K |
| Deutetrabenazine | 68 | $325K |
| Valbenazine Tosylate | 21 | $155K |
| Aripiprazole | 27 | $76K |
| Brexpiprazole | 68 | $75K |
| Lumateperone Tosylate | 37 | $58K |
| Clozapine | 438 | $38K |
| Divalproex Sodium | 714 | $34K |
| Chlorpromazine Hcl | 44 | $23K |
| Cariprazine Hcl | 15 | $22K |
| Vortioxetine Hydrobromide | 61 | $20K |
| Amantadine Hcl | 187 | $17K |
| Risperidone Microspheres | 13 | $15K |
| Patiromer Calcium Sorbitex | 13 | $15K |
| Fluphenazine Hcl | 45 | $12K |
Prescribing Profile
83
Unique Drugs
21.0
Anomaly Score
Patient Profile
72
Avg Age
57%
Female
2.13
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