⚠️

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 →

Paul SmithANP

Nurse Practitioner · New Boston, TX 75570

NPI: 1083616080

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15

🟡 Moderate

ML Fraud Detection Score: 85%

Machine learning model identifies prescribing patterns consistent with confirmed fraud cases. This is a statistical indicator, not an accusation.

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Risk Flags

Elevated antipsychotic prescribing (65+)Opioid + benzodiazepine co-prescriber

Risk indicators are statistical patterns, not allegations. Learn more

9,063

Total Claims

$368K

Drug Cost

516

Beneficiaries

$714

Cost/Patient

Risk Score Breakdown 15/100

Low (0)Moderate (15)Elevated (30)High (50+)
Opioid + benzodiazepine combo+8
Elderly antipsychotic prescribing+5

Score components are additive. Read full methodology

Peer Comparison vs. 218,535 Nurse Practitioner providers

-41%

Opioid rate vs peers

2.2% vs 3.8% avg

-39%

Cost per patient vs peers

$714 vs $1,174 avg

-36%

Brand preference vs peers

5.7% vs 8.9% 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

2.2%

Opioid Rate

203

Opioid Claims

$1,110

Opioid Cost

Long-Acting Rate

Brand vs Generic

94% generic

Brand: 508 claims · $227K

Generic: 8,456 claims · $138K

Top Prescribed Drugs

Drug (Generic)ClaimsCost
Apixaban47$51K
Insulin Glargine,hum.Rec.Anlog24$30K
Dulaglutide14$18K
Insulin Aspart18$17K
Sacubitril/Valsartan12$8,580
Montelukast Sodium559$8,071
Valsartan144$6,334
Atorvastatin Calcium375$4,773
Pantoprazole Sodium245$4,062
Gabapentin169$3,674
Levothyroxine Sodium288$3,514
Potassium Chloride165$3,348
Desvenlafaxine Succinate46$3,238
Losartan Potassium186$2,982
Albuterol Sulfate56$2,790

Prescribing Profile

122

Unique Drugs

$76K

IRA Negotiated Drugs

$18K

GLP-1 Drugs

15.0

Anomaly Score

Patient Profile

74

Avg Age

56%

Female

1.02

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