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: 85%
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
12,067
Total Claims
$1.2M
Drug Cost
535
Beneficiaries
$2,288
Cost/Patient
Risk Score Breakdown 24/100
Score components are additive. Read full methodology
Peer Comparison vs. 110,156 Internal Medicine providers
+87%
Opioid rate vs peers
4.2% vs 2.2% avg
+62%
Cost per patient vs peers
$2,288 vs $1,411 avg
+15%
Brand preference vs peers
12.3% vs 10.6% 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 85% indicates prescribing patterns with significant similarity to confirmed fraud cases. 17 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.
Opioid Prescribing
4.2%
Opioid Rate
506
Opioid Claims
$14K
Opioid Cost
—
Long-Acting Rate
Brand vs Generic
Brand: 1,449 claims · $878K
Generic: 10,367 claims · $333K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Sitagliptin Phosphate | 85 | $77K |
| Empagliflozin | 50 | $48K |
| Dulaglutide | 34 | $46K |
| Insulin Aspart | 20 | $36K |
| Apixaban | 53 | $31K |
| Empagliflozin/Metformin Hcl | 35 | $30K |
| Insulin Glargine/Lixisenatide | 33 | $29K |
| Insulin Nph Hum/Reg Insulin Hm | 62 | $28K |
| Sitagliptin Phos/Metformin Hcl | 38 | $27K |
| Dapagliflozin Propanediol | 34 | $25K |
| Sitagliptin Phos/Metformin Hcl | 28 | $23K |
| Semaglutide | 20 | $21K |
| Lipase/Protease/Amylase | 20 | $20K |
| Dapaglifloz Propaned/Metformin | 30 | $20K |
| Insulin Glargine,hum.Rec.Anlog | 46 | $20K |
Prescribing Profile
Patient Profile
77
Avg Age
53%
Female
1.80
Avg Risk Score
Explore More
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